Thyroid UK
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What to ask GP?

Hello all!

Just a bit of advice please. I have brought my September appointment forward to discuss b12, folate results Etc because I feel so tired and out of whack.

I am hoping he will suggest some b12 injections as I have heard they work faster.

If he says these are not necessary, is there anything else I should ask for?

I notice on my Levo info that ferrous sulphate is iffy, I assume ( ha you should never assume with a doctor ) he will be aware of this.

My bloods were

B12 / folate level 185ng/L 190-910ng/L

Serum folate 11·1ng/m/L. 3·30-99999·00ng/mL

Serum ferritin. 9·5ug/L 30·00-400·00 ug/L

Appointment on Wednesday

Thanks in advance


11 Replies

Hi pinkpeony

First tell him that you have come to him to discuss your blood test results. You want to recover your health and get on with your life.

Without even asking him he should certainly do something about your B12. He has to make sure why you are deficient, is it P.A.? He has to clarify this by another test, I believe. He should then give you injections to bring your B12 up past the halfway mark if not higher. We should really be towards the upper level. If he only gives you a set number of injections and you make sure you don't have P.A. you can supplement with sublingual methylcobalamin B12 and help Thyroiduk by using the Amazon Affiliate link. He should also deal with your low ferritin/folate levels.

I see from your profile that you had your thyroid gland knocked out by RAI, my personal opinion is that you should also have some T3 added to your T4. That's the very least you need.


Thank you Shaws.

I have just had a thought, I am taking one of the new anti - coagulent is it possible it could cause these readings?

Sorry I know medical queries are a no no.




I think you can ask a question if you are taking something that may interfere with your thyroid meds. I wouldn't have thought it would affect your B12 reading.

This is an excerpt and I should think your GP (hopefully) knows the following. I think it depends too on whether you were on levo before your anti-coagulent.

Two quotes:-

1. Those who are on stable, appropriate doses of both warfarin and levothyrozine should be all right as long as their thyroid function is stable and the measure of blood thinning, the INR, is in the normal range.

2. In order to avoid such harmful interactions, patients need to know that their thyroid status can affect their warfarin requirements. More frequent blood tests when starting levothyroxine can monitor a person’s response to the anticoagulant, allowing prompt adjustments as needed.


Ask for further testing for b12 related disorders, MMA homosyctine IF antibodies to rule out PA (or diagnosis) dont suppliment until further testing is done! If he refuses ask for haemotology referral. Read up on the new guidelines below print out and take with you page 29 if you have symptoms and dont think the GP will act as many are unaware of the updated guidelines, but read it all if you can, there are a few other points which would be good to quote.

be aware that even if they do offer you injections, you get (or should get) 6 loading doses in 2 weeks then put down to 1 every 12 weeks which is not sufficient for most people.

If you have facebook then join this group for further info/help

1 like

Thank you for your prompt reply.

The problem I am going to have is that my own g.p is on holiday and the guy I am seeing is an arrogant b*****d

Will do my best.



Pinkpeony, read through this link and print off and highlight what it says about loading and maintenance injections for your GP.

Pernicious anaemia may need to be ruled out before starting injections but if your GP refuses B12 loading injections ask for a 2nd opinion from another GP or change GP. If you have PA you will need lifelong injections but if your B12 deficiency is due to dietary vegetarianism then after the loading doses you should be able to supplement with sublingual lozenges, spray or patches. Your folate may need supplementing if you have B12 injections.

Iron isn't iffy with Levothyroxine. It just needs to be taken 4 hours away from Levothyroxine so it doesn't prevent absorption of Levothyroxine. Take each iron tablet with 500mg-1,000mg vitamin C to aid absorption and mitigate constipation.

1 like

Thank you Clutter. Read and understood.



PP, anticoagulants can affect absorption of Levothyroxine so you should ask for a thyroid test 8 weeks after starting the ac to see whether your meds need adjusting.


Been on Levo for 18 months, Eliquis for 8 months so whatever will happen has happened already. Will see what doctor has to say.

Thanks Clutter


I agree that your GP should do something about your B12. However he probably won't, and will describe your B12 as 'normal'. This is what happened to me. The NHS trust I was in had a cut-off point at 180ng/l, I was 182 (180-1000). So if you are over 180, you are fine, 'no action needed'. However if you are under 180 then you get injections, or more tests (depending on GP). Stupid isn't it?

I'd ask for the 'Active B12' test which should be the first test GPs do really. Take a look at for more information, or simply search on here for 'active b12' for lots more information.



Thanks for your reply.

Got a sooner appt made today and doctor was brilliant.

He put me straight on to injections and I had the first one today.

He also sent me for more blood tests, don't know what but nurse filled 3 phials.

Thank you for your interest.

Best Wishes P.P


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