Thyroid UK

May I have comments on my sister's vitD, B12 and white blood counts please?

Surgically hypo after RAI for Graves TSH is 0.94 (0.35-5.5) and FT4 18.9 (10.0-22.7) so all good there. Calcium, ferritin & cholesterol are good.

VitD 44 nmol/L (insufficient 21-50). She has a prescription to collect but hasn't said what dose.

If it's silly like 800iu, I'm thinking 5,000iu daily for four weeks, then 15,000iu weekly until high summer or retest. Thoughts?

B12 285 ng/l (190-900) Folate is mid-range.

I'm thinking 2,000mg Jarrows sublingual daily. Thoughts?

No Action Required but flagged Abnormal:

Total White Blood count 3.9 x 10^9/1 (4.0-11.0)

Mean corp haem (MCH) 33.5pg (27.0-32.0)

Neutrophil count: 1.8 x 10^9/1 (2.0-7.5)

Do those results hint at a touch of infection somewhere?

She's lost her iphone, shall I blame her low B12 and vitD deficiency?

Thanks for your help. I ought to dig my results out for interpretation soon too :-D

15 Replies

with such low but in range B12 if I was symptomatic for it I would look at 2 possible routes:

1) if I want a diagnosis I would 'not' supplement at all, if I was supplementing before the test I'd stop and repeat the test 4 months later. I'd look into having the active b12 test and methylmalonic acid and homocysteine blood tests

2) if I am not interested in a diagnosis I'd just supplement, if I had severe symptoms or neurological symptoms I'd look at injections and if I do not want to self treat I'd look at a private doctor to back

me up. If my symptoms were not as bad and not neurological I'd take 5000mcg sublingual daily for as long as I can afford it (even months and years) and would only reduce to 1000mcg once I have been symptom free for a while.

that is what 'I' would do :)

PS slightly low white blood cell count does 'not' point to infection, but it may well be related/connected to the B12 problem or may be just temporary, I'd repeat the test maybe a couple of weeks later to check if it's still low as it is only slightly low.


Thanks Nobodysdriving. She hasn't any symptoms and tested at my behest. Surgery has said No Action Rqd so it'll be self supplementation and it won't be jabs:-D


...think you may mean 2000 for the B12 dose :-) B12 result very low. Have learnt a thing or two from hampster1 about PA and deficiencies of B12 etc. I think she would say that B12 result is very LOW. Remember that only 20% of that result can be used at a cellular level. Also B12 needs to be taken with Folic Acid as they work synergistically. If she has gut issues it may work better to use the Hi-Strength B12 patches - as they have all the B's in them as well. Again I have used them.... Most of the B12 is absorbed in the Terminal Ileum.....and needs IF - Intrinsic Factor - from the stomach cells to bind with the B12 molecules before transportation onwards.... If there are problems there that could also cause low B12 in the blood.

I agree with the VitD and personally have had very good results with high doses.

Not sure about the infection bit - am sure someone more knowledgeable than me will be along soon. Could be the RAI has unsettled things - it is not a naturally occurring thing in the body so may cause a reaction - just a thought....


Hi Marz, yes I meant 2,000mg :) RAI was 2011 so I think it's more likely low B12 has stressed her system as Nobodysdriving suggested. She has no gut issues.

She has some joint and bone pain, not that it stopped her from joining a running club recently, and is why I suggested she test vitD.


...with you on the case - all will be well :-)




Sorry but thought b12 had to be taken with vitamin c have i got this wrong do I need folic acid as well


You could be confusing B12 with Iron - which does need VitC I believe.....


Woops better go get folic acid thank you


As Marz, says vitC is taken with iron to aid absorption. It is a good idea to take folic acid with B12 if you don't know your folate score as they are co-dependent and work best together.


Thanks il get some


Hi Clutter I came across these snippets hope they help and not add to the confusion,

Simply increasing vitamin D intake won't necessarily reverse your deficiency, says Michael Holick, M.D., a Bone Health Care Clinic director at Boston University Medical Center. However, "anywhere from 40 to 60 percent of patients benefit by correcting their vitamin D deficiency," according to a 2008 interview with Holick in "Alternative Therapies." His recommendation is to take 50,000 IU of the vitamin once a week for two months and every other week thereafter. In Holick's experience, prescription therapeutic supplementation of this kind can return blood serum levels of the vitamin to normal. While you can get an over-the-counter vitamin D supplement, Holick suggests that a prescription from your physician has better compliancy rates. After two or three months, you may experience a feeling of overall well-being. min-d-important-thyroid.htm

Richard Shames, MD:Make sure it is Vitamin D3. I usually recommend that my patients take at least 2,000 IU per day for maintenance, 4,000 per day if they are at the lowest end of the low-normal range, and 6,000 per day if their tests showed Vitamin D levels below normal. I typically recommend patients supplement for two to three months, and then get retested to monitor improvement. I usually have patients who were low or borderline move to the 2,000 IU maintenance dose when blood levels have reached 50 to 60 or better.

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Thanks Flatfeet. I was recently vitD deficient and loading and maintenance doses lifted me well up in range. Just hoping her GP will do the same but don't want her stuck on 800iu. Thanks for the links which I'll read later :)


Hi there I have been similar to you with results like that for a long time, the high MCV indicates possible Pernicious Anaemia but with all the rest classed as normal range they will just ignore it. The low white blood count is not infection, if you had an infection anywhere your white blood count would be too high, not too low as they are the cells that fight of our infections. Our body produces more if we get an infection to help fight it off. My blood tests have carried on like this for a few years but I have suddenly gone grossly hypothyroid even on 175mcg of levothyroxine. I have been told that my thyroid having problems can cause my other blood results. Your normal range is different to ours for some reason too, FT 4 (11-24) and TSH (0.35-4.5)!


Thank you. The results are my sister's. Her GP is generally very good but is retiring soon so I've been pushing her to sort things out. Ranges differ all over the country which is why they're requested here.


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