Sophiethecat, both sets of antibodies are positive for autoimmune thyroid disease (Hashimoto's). You might try 100% gluten-free diet which has helped Hashi patients reduce Hashi flares and antibodies.
High ferritin can be due to over supplementation of iron. It can also be due to inflammation. High CRP and ferritin don't indicate where in the body the inflammation is, so your GP may want to investigate and do a full blood count. Some autoimmune diseases can cause inflammation so it's possibly due to Hashimoto's.
TSH is suppressed as expected on 150mcg Levothyroxine and 20mcg T3. FT4 and FT3 levels are good and don't indicate overmedication.
B12 227 is low, <500 can cause neuropathy, and 1,000 is optimal. Supplement 5,000mcg methylcobalamin sublingual lozenges, spray or patches for 8 weeks, then reduce to 1,000mcg to maintain levels. Take a B Complex vitamin to keep the other B vits balanced. Folate level is good.
Clutter, I'm surprised you have said the folate level is good. The result given
Serum Folate = 13.14 (10.4 - 42.4 nmol/L)
is only about 8% of the way through the reference range. I thought we were supposed to aim for a minimum of mid-range, which is about 26 - 27 nmol/L, but were not supposed to go above the top of the range.
I know that the reference ranges for folate vary widely from lab to lab and perhaps that is the cause of the confusion?
HB, I wasn't aware there is an optimal folate level within range. If Sophie supplements B Complex with B12 her folate 13.4 will increase anyway. High folate through diet isn't a problem as long as B12 is normal, presumably within range.
He wanders off into discussing a test I've never heard of before called the NHI test, but it is still worth reading, particularly about supplementing with folate rather than folic acid.
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I also found this paper which is interesting :
Title : In vitamin B12 deficiency, higher serum folate is associated with increased total homocysteine and methylmalonic acid concentrations
A quote from the paper (I added the bold effect) :
We recently examined the interaction between serum folate and vitamin B12 status in relation to anemia, macrocytosis, and cognitive impairment in older participants (age ≥60 years) in the 1999–2002 United States National Health and Nutrition Examination Survey (NHANES) (11). As expected, low vitamin B12 status was associated with all three abnormalities. Furthermore, when vitamin B12 status was normal, high serum folate was related to protection from cognitive impairment. Among those with low vitamin B12 status, however, high serum folate was directly associated with both anemia and cognitive impairment. Consistent with our findings for subjects with normal vitamin B12 status, several cross-sectional studies (12–15), as well as some prospective investigations (16–19), have reported direct relations between folate status and cognition. On the other hand, Morris et al. (20) found that higher folate intake was associated with more rapid cognitive decline in a cohort of ≈4,000 community-dwelling elderly people whose vitamin B12 status was unknown.
Okay, I'm happy now, I think. As I understand it, high folate is desirable as long as vitamin B12 is normal. But when B12 levels are low or deficient, high folate levels must be avoided.
HB, I'm not saying there isn't an optimal folate level, just I'm not aware of it, or what it might be if there is one.
There's something called the The Methyl Folate Trap where high folate can mask B12 deficiency. I bookmarked this link but find it too technical to comprehend thelancet.com/journals/lanc... Google for more comprehensible articles.
This is my understanding from various bits of reading I've done, but would like it confirmed from someone more familiar than me with B12 deficiency...
B12 deficiency can show up in some ways in a full blood count test - something to do with the size of red blood cells? If a doctor sees these signs in a full blood count then they would then get a B12 level and a folate level done and treat accordingly.
The problem arises when people with low B12 take folic acid or folate supplements. It alters the results of a full blood count in such a way that the signs of B12 deficiency no longer show up and the patient is declared to be fine. So a patient is left to get more and more B12 deficient, and all sorts of problems arise as a result of this hidden deficiency.
The thing is that many foods are now fortified with folic acid. So I imagine the numbers of people who are becoming B12 deficient must be rising.
But if people know both results (B12 and folate) the question of disguised B12 deficiency doesn't arise.
HB, That's pretty much the way I understand it. I suppose it depends on how much fortified folate is in the diet as to whether it would mask B12 deficiency.
One thing I would add to the posts above ... If you are supplementing with anything containing any form of iron e.g. a multivitamin, I would stop it and find an alternative which doesn't contain iron. Such supplements are available, or so I've heard, but I've never investigated them personally.
Having high ferritin (storage iron) is a side effect of either taking too much iron in supplement form, or your body is withholding iron from your cells by storing it in ferritin because you have inflammation or infection. Since you are not supplementing iron, it must be the second reason.
Your CRP (C-Reactive Protein) level is high - well over twice the top of the range. CRP is an indicator of how much inflammation or infection there is in your body. In the presence of inflammation or infection, your body prevents iron being made available to your system by storing it in ferritin.
So the sequence of events is :
Develop inflammation or infection
which leads to High CRP
which leads to high ferritin.
It won't be that simple of course - the three things are intertwined rather than happening one after the other, but it gives you an idea.
The results you have for antibodies show you have autoimmune hypothyroidism/Hashimoto's (this is the commonest kind of hypothyroidism in the UK). Having this type of hypothyroidism causes all sorts of inflammation, and one of the main areas is in the gut.
So, the thing you have to do is to lower your inflammation levels. If you succeed, then your levels of CRP will drop. Then your ferritin will drop too. And you should feel a lot better.
Reducing inflammation is not easy, but one way that helps many of us is by eliminating gluten from the diet. Do you have lots of gut problems? Do you take lots of antacids? Do you take acid blockers?
One person who writes extensively on the subject of inflammation and Hashimoto's Disease is Izabella Wentz. She is a sufferer herself, has written a book on the subject, and has several sites on the web which are worth looking at :
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