Thyroid UK
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Some help with folate/ zinc etc blood results please?


I've posted briefly before and got some good advice so was hoping for some again as I am unsure how to progress.

A brief history. I have had alopecia since the age of 8 and diagnosed hypothyroid since my early twenties. All was managed well until after the birth of my third child (who is now 5). Since then I have felt dreadful (to put it mildly). I am 41.

After some advice and reading here I managed to (a) see an endocrinologist for the first time and (b) be given t3 alongside my thyroxine. I've been taking it for 2 months and have had my latest bloods through which I will post below.

I had been on 150mg for years and was over medicated so Dr reduced to 125 and prescribed 5 of t3 twice a day also. Upon receiving the new blood results he has suggested dropping to 100mg and continuing with the T3 at same levels which I think I agree with. However, I feel so much better by adding the T3 I am wondering how I would know if I might need more? Also, I think my other blood results are not great but he is perfectly happy with them. Any advice please?

Apologies for the mammoth post!!!!

Latest results

TSH 0.08 (0.3-3.94)

Free T4 24.9 (12.3-20.2)

Vit B12 204 (191-663)

Folate 3.7 (4.6-18.7)

Vit D 67 (<30 deficient,30-50 inadequate for some, >50 sufficient for most)

Zinc 12 (11-24)

RBC 4.20 (4.32-5.6)

Thank you in advance


4 Replies

Sasmit, FT4 is quite a bit over range which is why TSH is so low. Reducing to 100mcg will probably see FT4 drop close to the top of range. If you continue to have hypo symptoms you should have a FT3 test to check levels. If low, you will need more T3.

Folate is deficient, your GP should prescribe 5mg folic acid for 2-3 months. RBC is likely to be below range because of folate deficiency.

B12 is very low, but is within range, so your GP is unlikely to prescribe. Supplement 5,000mcg methylcobalamin sublingual lozenges, spray or patches for 2-3 months then reduce to 1,000mcg. PA Society advises B12 1,000 is optimal. Take a B Complex vitamin to keep the other B vits balanced.

Supplement 15mg zinc and 325-375mg magnesium with it as they are synergistic.

VitD is replete 75-200. You need to supplement 2.500iu daily D3 to maintain levels during October-April when ultraviolet light is too low to stimulate vit D.


Thank you for such a thorough reply - exactly what I was hoping for!! Shall go and sort all that tomorrow.

I have been low on folate three times in 2 years so wondering if I have some sort of absorption issue?

Same with Zinc and my eldest son also has a zinc deficiency and alopecia universalis. Do you know whether there is a particular reason why we might be low ie does autoimmune cause mal-absorption or vice versa? Clutching at straws but desperately want to help my sons alopecia and/ or avoid hypothyroidism for him too!

Thanks Sarah x


Sarah, when you have several deficiencies malabsorption is very likely. Ask your GP to test tissue transglutamine (tTg) to rule out coeliac disease due to gluten intolerance. If you have coeliac first degree relatives should be screened for it too.

A negative tTg doesn't conclusively rule out gluten as an issue, some people aren't intolerant, but do have sensitivity which can cause malabsorption. It could be worth trying 100% gluten-free for 3-6 months after a negative result to see whether absorption improves.

Low zinc can cause some hairloss/thinning but not total loss as in AU.


Thanks again. Our whole family was actually tested for that last year due to high prevalence of auto immune but the result was negative.

Will supplement and hpefully getting those levels right will be the last piece of the jigsaw and I can keep my T3 as it is (Endo not at all keen on prescribing it and wants to see 'significant' improvement in order to continue!!).

Thank you again for sharing your knowledge!



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