Thyroid UK
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Fed up!

Just been for my blood results, saw a locum and I've left the surgery in tears.

B12 (128) range 180 - 914

Ferritin (38) range 11 - 307

Folate (6.6) range 3.1 - 19.9

TSH (2.78) range 0.2 - 4

Im due to start loading doses of b12 tomorrow.

Told the dr it was my understanding that al of the above needed to be mid to high range to get The full benefit of Levo. He disagreed, saying I could supplement these myself if I wanted to.

He then wanted to keep my Levo at 125mcg because I am in range. I explained my last reading was 1.44 and that I feel better lower down. He said again that I am in range. I lost it a bit and said he wasn't treating my symptoms. He then suggested alternating between 125 and 150 Levo.

So my question to you all is, how much do I need to take of ferritin and folate daily?

And, does anyone know why my b12 would suddenly drop when it's been fine for approx 2 years? I've already had a negative result for antibodies, suggesting pernicious anaemia unlikely.

Sorry in advance for the long post, I'm just really fed up of feeling like this.

10 Replies

Crazymam, B12 that low will make a person feel tired. Why did it get that low? Check dietary sources. I don't know what you mean by 'loading dose'? Injections or large oral doses?

At least the doctor managed to 'haggle' with you. Alternating doses is better than him being a stick in the mud. Were you feeling well while on 150 mcg T4? I agree, your TSH is currently too high. It was not 'low' on 150 mcg. It was 'normal for a euthyroid patient' but possibly not 'ideal' for a hypothyroid patient taking thyroxine. Could go lower and be fine.

Check your dietary sources of vitamin A as well.

Vitamin D was not tested.

I'm sure Clutter will give you the recommendations for supplementing optimally.


@gabkad thanks for the reply,

I should've explained properly. I was on 125 Levo and felt awful so went to Drs for bloods.

Came back that my b12 was low. I really don't know why it's dropped. We eat relatively well - well balanced. That's when I asked what the other readings were.

I had bother with my b12 after my 3rd child was born, when it dropped to 19. I was also borderline hypo then. After a couple of years of being borderline I asked a different dr for a trial of Levo.

The loading doses of b12 consist of 3 injections this week, followed by 3 next week.


That's dire: 19!!! Once your B12 level comes up you will have more energy. I guess once you are done with the injections, you can take sublingual B12 or the oral spray.


I know.

I've ordered the spray off amazon. Just waiting for it now.


Crazymam10, I don't think your folate needs supplementing but it is a good idea to supplement B Complex which has a small amount of folic acid or methylfolate when you are having B12 injections. I think it is possible to have false negative parietal cell antibodies so perhaps they could be retested along with intrinsic factor.

Vegetarian and vegan diet causes low B12 and once B12 levels are restored you should supplement B12 if deficiency was due to lack of meat in your diet. If you eat meat, fish and eggs it is likely that hypothyroidism has caused low stomach acid which makes it difficult to cleave nutrients from food. You can raise stomach acid by taking raw apple cider vinegar in fruit juice or honey-sweetened water before meals, or Betaine Pepsin before meals.

Most people will be euthyroid when TSH is just above or below 1.0 which is also in the normal range. The alternate dosing 125/150mcg may be enough to help but ask for a retest in 6-8 weeks to check. Read Treatment Options in Email for a copy of the Pulse article if you would like to show it to your GP.

Supplement 210mg Ferrous Fumarate and take each tablet with 500mg-1,000mg vitamin C to aid absorption and minimise constipation. Take iron 4 hours away from Levothyroxine. Retest ferritin in 6 months.


I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.


Clutter thanks so much. Could the raise of TSH have caused The b12 to drop then do you think?

I'm only thinking that because I haven't had any problems with low b12 since starting Levo a few years ago, seems strange it's now low again.


Crazymam10, I think it takes several years for B12 levels to drop significantly. If TSH has risen over a few months I doubt that will be the reason.


I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.


I'll give the honey sweetened water a try. The other option screams heartburn. Haha. Thank you.


Crazymam10, the honey-sweetened water is to make the raw apple cider vinegar palatable. You need a couple of teaspoons of ACV in it to raise stomach acid.

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Ah haha. Read that completely wrong didn't I. 🙈

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