Optimal Folate & Ferritin levels in hypothyroid patients

Hi. I have just had some more blood test results back:

B12 340ng/l (Range 120 - 165)

Folate 10.4ug/l (no range given i did ask!)

Ferritin 19ug/l (range 11 - 307)

TSH 2.08 (Range 0.34 - 5.6)

T3 4.2 (Range 3.8 - 6)

T4 13.9 (Range 7.5 - 20.00)

I have read that in order for levothyroxine to work best that certainly folate and ferritin need to be optimal but it would seem that the medical centre i go to is saying that everything is okay. I am currently taking 125mcg levothyroxine daily and no supplements. I feel exhausted most of the time, i am getting strange tingling sensations in my face, hands and feet. Any advice would be most appreciated. Thanks.

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  • B12 and Ferritin are LOW....only about 20% of the B12 showing in your blood can be used at a cellular level where it is needed. No wonder you are feeling tired and tingly.

    b12deficiency.info/signs-an...

    b12d.org is another good one where there is a questionnaire that changes colour according to your B12 status.

    Considering your T4 dose the thyroid results are also LOW. You may feel better with a TSH of 1 or below. Do you have Hashimotos ? Have your anti-bodies been tested ?

    chriskresser.com/b12-defici...

    Good luck and hope you soon feel better....

  • Hi Marz

    I am wondering if maybe i can ask my Doctor to up the levothyroxine from 125mcg - 150mcg or would i better off taking some B12,Folate and Ferritin or a good combined B vitamin? I have done the B12d.org and came out at 66 which i am guessing is low? I do have antibodies but have not been diagnosed as having hashimotos disease. The endocrinologist i saw a couple of months ago seems to think my treatment was started to early!!!

  • It is probably best to improve your Iron/B12 status before increasing the dose of T4. As good levels are needed for conversion of T4 into the ACTIVE T3. Taking a B Complex is not adequate in most cases as you will need to take more than the suggested dose in order to obtain enough B12. That may involve overdosing on some of the other B's.... Amazon sell B12 patches - Hi-Strength which may help with all the B's, Folic Acid too.

    Do you have your Anti-bodies result - with range ? Gut issues ? The result of 66 is not the same as a blood test result.

  • your ferritin MUST be over halfway in the range or you cant convert/utilise Thyroxine so your ferritin level is way way way too low it miust be over 150

    i have posted links to research that backs this up on a thread titled "more on ferritin and folate "

    so your surgury is WRONG and its likely that your tingling sensations are toxic effect of thyroxine because you cant utilise it

  • Hi

    You kindly replied to me a few weeks ago that Ferritin should be over mid range.

    I have looked at the thread and the link says should be over 70

    Can you please point out where it states it should be mid range.

    Many thanks browny

  • I cant print or fwd any links currently as i am away

    the over 70 applies to the 13 to 150 range

    the ferritin range you quote is 11 to 307 hence it must be over 150

    GPs and Doctors refuse to face that fact because NHS simply do not care how ill you are or why thyroxine does not work .............they have this crazy notion that if its 11 or more your OK which is total and utter rubbish

  • Thank you, mine level is 65 so I am way off, I am taking one sachet of spatone a day but I am now wondering if it is enough

  • Browny

    level of 65 ..............in what range ?

    these labs confuse everything by having different ref ranges

  • Sorry range 15 - 300 but last year it was 88 same range and when I posted on this forum the level and range this when I got replies saying it was O.K. as it was over 70

    so this is why I am so confused

  • Thats why we always ask for the ranges

    lately it seems all the labs have introduced different ranges just to confuse

    hence why i always say over halfway in the range ..............which for you on the 11to 303 range needs to be at least 150

  • Many thanks for explaining

  • Folks, I'm confused. I asked about what ReallyFedUp advised on the Facebook Thyroid site (USA) and the administrators have told me: The units (ug/L) your lab uses to measure your ferritin are international/universal. To shoot for mid-range 200 may not necessarily end up helping you feel any better. It appears although ranges differ, the optimal level does not. Your range is a broader range but optimal should be 70 - 90.

  • reallyfedup123 - I'm confused now! My own ferritin is 153 ug/L (range 23-393) I asked about what you mentioned re being half way in the range, on the Facebook Thyroid site (USA one), and the administrators told me this: ' The units (ug/L) your lab uses to measure your ferritin are international/universal. To shoot for mid-range 200 may not necessarily end up helping you feel any better. It appears although ranges differ, the optimal level does not. Your range is a broader range but optimal should be 70 - 90.' Any thoughts??

  • Yes, stop worrying. You are already above the 70-90 optimal range and not far off the half way range. Ferritin is a moveable feast. It's a iron storehouse the body can call on when it needs more iron and it's a dump the body chucks excess iron back into. Low ferritin needs iron supplementation and high (over range) ferritin needs investigation as it can denote illness and possible liver disease/damage.

  • Yes, but according to The US forum folk, I must have inflammation with ferritin of 153, but my WBC, ESR and CPR are all perfect, so I don't see where inflammation could be from. My pernicious anaemia and thyroid are all being looked after with B12 injections and Erfa dessicated thyroid hormone and I follow coeliac diet and take iron - yet T3 remains at low end of range and TIBC (iron) is low as is RBC (red cell count) and I have rotten muscle aches all over...when I try to raise Erfa past 2 grains I get worse unless I take massive doses of iron (taking chelated iron from Bluebonnet)...then I get a little better RBC and TIBC, but not much...

  • PS Liver function tests are great - well within normal range. Cholesterol HDL ratio is 2.6, which doc calls 'excellent'. So I'm really puzzled about this high ferritin. Anything else besides liver that causes it? I do have poor glucose tolerance on the challenge test (albeit in the presence of normal fasting glucose of 5..)

  • I suspect that taking massive amounts of iron will be the reason you have ferritin of 153, nevertheless it isn't high being less than halfway in range.

    Muscle aches can also be caused by low vitamin D and B12. I assume you are having regular B12 shots but has your vitamin D been checked?

    There have been problems reported with Erfa in the last few months. Have you considered changing brand or even adding in some T3 to your Erfa to raise your FT3?

  • Clearly the labs are determined to confuse everyone

  • It's a real pain isn't it? The US forum folk are telling me I must have inflammation with ferritin of 153, but my WBC, ESR and CPR are all perfect, so I don't what could be signalling inflammation...

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