This weeks blood test

[Mazzi133]

Hi everyone,

My results are above, how much b12 should I be taking? Do I need to take any other vitamins while supplementing b12?

Also my tsh keeps dropping, what could this mean?

October 2015 - 5.21 (afternoon not fasting)

December 2015 - 4.01 (afternoon not fasting)

May 2016 - 3.89 (8.30 am fasting)

This week It's gone further 3.26 (8.30 am fasting)

I'm seeing a private doctor (dr b willis) next week

Just to add I'm not being treated by my gp only one gp in my surgery acknowledges that I have subclinical hypothyroidism.

Any input would be fab, also any feedback on what I should discuss with him would be great.

[Mazzi133]

Hello,

Thanks for your reply, I will mention the other tests to him. Interesting as I've been getting cold sores since I was a little girl - mainly when I'm stressed only. Never thought there could be a connection to Hashimotos.. Having a look at this article now

hypothyroidmom.com/hashimot...

I have not had any adrenal stress tests done.. Going to look into this too.

I'm still quite new to this/ in denial and just wish I was 'normal' like most people my age

His full name is doctor Bernard Willis I will be seeing him in London, video below

m.youtube.com/watch?v=AD2j3...(Not working as expected?)

[Ruthi]

Dr Wills may well order the adrenal tests for you - his colleague Dr O did for me. He also ordered a urine test to look at mineral status.

Your B12 is low enough that you should probably be having injections. Sublingual tablets will be very slow to work. Also you need to be tested for pernicious anaemia, another auto-immune disease which causes low B12 and ultimately anaemia. Sadly it often goes with Hashis. It would be a good idea to join the Pernicious Anaemia Society board here on Healthunlocked.

Although your folate is in range, its also really too low. You need methyl folate tablets, not folic acid which is poorly absorbed and utilised.

Your free T3 is high enough that, if that were your only problem, I would not expect you to feel too bad, although the high TSH tells a slightly different, and incongruous story. You would feel a hell of a lot better with a decent level of B12, that is for sure!

[Mazzi133 in reply to Ruthi]

Hi Ruthi,

Thanks for the tips. I ordered folate supplements from the brand solgar (not folic acid).

I don't know how much and what combination of vitamins I need to be taking, I want to speak to dr Willis first.

I've also ordered these for b12

amazon.co.uk/Vitamin-Methyl...

I asked go about optimal ranges in each of these vitamins I was tested on because some seem in the lower end of range and she said I don't need to focus on any in particular or I could just use a multivitamin.

My main symptoms are ibs, fatigue, joint pains.

[Gambit62 in reply to Mazzi133]

Your GP is useless on B12 - if you have symptoms and your .evels are that low you should be being treated for a B12 deficiency as above.

Left untreated a B12 deficiency will kill you ... not because of the anaemia it causes (which is just another symptom) but because without it your cardio vascular system and your nervous system will stop functioning. However, most GPs are totally fixated on anaemia and if you don't have any signs of anaemia (macrocytosis generally) then it will be dismissed as a possibility ... particularly as some of the key symptoms will probably be put down to thyroid in your case.

Suggest you draw your GPs attention to the following two documents

bcshguidelines.com/document...

page 2 summary if you have neurological symptoms

page 8 re treatment regimes

ukneqas-haematinics.org.uk/...

an alert about the need to treat on basis of symptoms not test results as symptoms can be sever well into the normal ranges identified by labs

Unless you are a vegetarian/eat very little meat/fish/dairy then the deficiency is down to an absorption problem - so trying to use the gut to get B12 in to you is going to be inefficient at best. A normal multi-vit has such low levels of B12 in it that it will be useless.

Most absorption happens in the ileum - 99% so in theory taking 100x RDA could result in enough getting through to meet your daily needs - usually if you are trying oral the recommendation would be 1000-10000mcg (ug) a day. But it really doesn't work for everyone - sublinguals work a bit better because they are supposed to be absorbed through membranes in the mouth - other options are nasal sprays and skin patches ... but it is hit and miss.

Your body needs folate in order to fully process and use B12 and your folate levels aren't great.

Methyl gets pushed a lot - both folate and B12 but it may not be necessary. Some people do have problems converting vitamins to the fully methylated forms that are used at the cell level but this can generally be overcome by taking higher doses of the vitamins. A folate methylation problem often show up as high levels in blood because it sticks around in the blood because the body isn't able to use it - and some people don't respond well to methylated folate because they are actually super-methylaters. There are some specific genetic markers involved.

Methyl B12 also gets pushed because it is closer to the forms used at the cell level but reactions to it are also mixed. It isn't clear why but one possibility is that the body actually needs 2 forms of B12 and they are used for different processes but there are documented cases where people had problems converting methyl to adenosyl ... so if you don't respond it is worth trying adding adenosyl into the mix or even switching to an unmethylated form and seeing what happens.

B12 isn't toxic.

[Mazzi133 in reply to Gambit62]

Thank you I've got a appointment with private doctor this week will discuss getting tested for p.a with him

[Gambit62 in reply to Mazzi133]

pa is only one possible cause of a B12 deficiency - and the tests are at best 50% accurate.

Not convinced about the recommendations to find out what the cause is - treatment is the same unless it is lack of B12 in your diet.

I'd focus on getting B12 deficiency confirmed and treated.

[greygoose in reply to Mazzi133]

1000 mcg won't be enough. You should take at least 5000. And, you should take a B complex with it to balance your Bs, as they all work together.

Your doctor knows nothing about nutrition, none of them do. A multivitamin is just a waste of money. There's not enough of anything in them to treat a real deficiency, and they contain things you don't want. And so many other reasons why you should never take a multi-vit.

What are your vit d and ferritin?

[Mazzi133 in reply to greygoose]

Hi greygoose,

Do these look good? I've ordered them from Amazon.

amazon.co.uk/Vitamin-Methyl...

I've already got folate that I'll start taking too.

I was diagnosed with vit d deficiency in May after taking d3 40,000 a day for 1 week I've gone from 25 to 72, taking 2 x 20,000 a month now.

Ferritin is 81.7

[greygoose in reply to Mazzi133]

Well, they're only 1000 mcg and you do need more than that daily. It will mean taking at least five of them a day.

Still a little way to go with the vit D. And the ferritin could be higher, too.