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Recently had foliate tested and surgery phoned to say I need to get retested. Is there any connection with swollen lymph nodes?

Foliate was 1.7 range 3 to 20. Shld I be worried and is there any connection to swollen lymph nodes. Recently had ultrasound. Had Total thyriodectomy almost 3 years ago on 175 thyroxine. Suspected cancer but turned out to be Black shadow caused by two times radioactive iondine. Have felt tired for a long time.

14 Replies

Hi Foliates are normally done with B12 tests. They go together. They normally denote penitious ( sorry cannot spell that) anaemia . Treatment usually with B12 injections. They only go with thyroid in so much as they are both autoimmune diseases ( normally). It is very common and would make you eel bad. It ideally needs to be high in range, the B12 that is. Make sure ,also, that your iron/ferritin is well in range, Diabetes status is OK ( tiredness can be that ), vit d which is hormonal. The hospital should have done all these but check. You can and should always ask for a print out of all bloods + ranges as different labs vary. From receptionist, hospital sec. Keep

Best wishes,



Your folate is very very low, I would imagine your doctor will prescribe you 5mg folic acid to correct the deficiency. Some info here:


As Jackie says, if he is retesting folate he must test vitamin B12 as well, they work together, along with iron, in the correct formation of red blood cells amongst other things. It is very important to check B12 status before giving folic acid supplements, and you should ask for your iron and ferritin to be tested as well:



"Care should be taken not to give folic acid (instead of B12) to any patient who is B12-deprived, as this may result in fulminant neurological deficit.[3]"

"Oral iron therapy should be given before B12 if iron deficiency is diagnosed by an absence of stainable Fe in the bone marrow or other parameters (eg serum ferritin <449 pmol/mL).[3]"


After supplementing for some time with poor results, I found that for any people folic acid is NOT the best supplement as it does not end up as folate in many people, and might not be too good for you either! I have moved on to a much more easily absorbed type containing 5-methyltetrahydrofolate (typical it is a bit more expensive though!) and I take just 400mcg now too.

lots of info on-line... eg. chriskresser.com/folate-vs-...

Easy enough to get from Amazon, Health Monthly and others.


Many people do OK on bog standard folic acid, others as picton suggests, need a more active form, say if they have MTHFR genetic errors. Others can't tolerate the more active form. Same with B12. We are all different. It's up to you, trial and error is involved, unless you fork out for comprehensive genetic testing. I'm currently taking the bog standard folic acid to correct my deficiency, but my B-complex contains the more active form.


Even if not genetically compromised(!) just that when low, pumping up using larger amounts has the potential to be a bit harmful, and the safer option seems worth the small amount extra.

That said, I have on occasions thought about such testing.... 23andme.com/ is not a fortune, easy to do too - although I sometimes wonder if it might stimulate a degree of hypochondria! ;-)


I know what you mean! And actually I'm not sure I'd want to know all the things I might be predisposed to getting... I've heard that Dr Yasko's tests concentrate on the methylation defects and on things that we can do something about, but it is more expensive than 23andme? It's not something I'm ready for exploring in any case. But I agree with you, once the doc stops my prescription folic acid I'm going to keep going with my more active supplement. x

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Thanks for all the info. Got appointment on Monday for bloods, so will be armed with useful info and questions to ask. My mother has anemia, thyroid, diabetes so perhaps it is hereditary. Was on iron couple of years ago but had no follow up and frankly was pretty ignorant about the whole thing, once I finished the tablets that was it. I think there maybe a link between the deficiencies and the swollen lymph nodes. I am a bit annoyed that I had tests a few months ago and was told they were fine. Could this have got so low so quickly? If so its a bit of a concern. Will just have to be patient and wait for results. Thanks again.


Sorry brain fog! The radiologist said she didn't think the nodes were suspicious but then added that they were the largest she had ever seen. So reassurance then worry lol xxx


I found another link about folate and B12 that might be useful for you:


"So our view isn't that B12 causes folate deficiency nor that folate can cure B12 deficiency, but that both are needed at the same time. The key difference is that folate can be not so good for you in overdose, but there is no such thing as an overdose for B12. So take the right amount of folate to push your folate level towards the top of the normal range, but take any amount of B12."

B12d.org is a support group for B12 deficiency, lots of great info on their website.

If you are low on all these things (folate, B12, iron) you might want to ask your doctor to screen you for Coeliac Disease, H Pylori, Gastritis etc. Do you have any gastric symptoms?

H x


Meant to add, just because you were told they were fine a few months ago, doesn't mean they actually were. You might want to ask for back copies of your test results and have a look...


Suspicious by their sheer effrontery, perhaps? ;) & getting away with it, to boot!


Got TSH 0.06 (0.3 - 2.5) and Ft4 17.8 (7 to 24). They didnt do FT3. Also got call from doc to get some more tests wanted foliate B12 and some others tests. Nurse said she would add T3. When I saw him today he was more concerned with low white blood cell count, was shocked so not sure think it was 6 or 600. Have got to go back next week and he wants to do more tests. He said the TSH was okay. Not sure what to think. Any ideas?


Seems like you will have to get that FT3 to see if it's down below half range. I know the NHS doesn't like to stand the cost of them and sometimes an endo will be needed push for it -as they probably appreciate the meaning of T3 ratios etc. unlike GPs!

It's been said on here many times that with figures like your TSH and T4, the T3 is important at a guide to treatment success.

Hamster above has added some good points- what about the Gastric connection?


Have been rather constipated since my TT but just put it down to slowing down of metabolism after being many years overactive. I did go to GP and he just gave me medication. My stomach does seem pretty bloated and hard sometimes. When I was regularly attending Thyroid Clinic at hospital orginal endo was great and he insisted on T3 being done and even wrote to my GP but when I mentioned it and the GP just ignored me. Got bumped off endo list when good endo retired after I got TT. The GP seems more concerned about lymphocytes at this point being low. Hopefully will find out about the T3 also. Thanks for all you info gradually trying to assimilate it all lol x


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