Hi, ive been to the doctors multiple times asking about why i am always exhausted (im 16) and had a blood test i came back with

TSH 2.68. MU /L (0.035-5.5)

Serum ferritin 14.6 ug / L (10.0-291.0)

Folate serum 7.00 ug /L (>5.38)

Vitamin B12 496.0 ng /L (211.0 -911.0)

(Take in morning but not fasted)

The doctors says i am not anaemic but iron levels low. I am going to do a blue horizon test for thryroid antibodies FT3 and FT4. My family feel as though i need more to supplement ferritin with vitimin C and B12 and B vitimins. I would appreciate any advice you could give thank you.

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6 Replies

  • Your low ferritin will contribute to you feeling exhausted. But your folate and B12 aren't brilliant either. With all of these being low, or lower than optimal, it suggests you have problems with the absorption of nutrients from your food.

    I wouldn't be surprised if your vitamin D was too low as well.

    Your TSH of 2.68 is on the high side for someone with a completely healthy thyroid. It does suggest that hypothyroidism might be an issue for you sometime in the future. But there is no way of knowing when that will be. Your thyroid may chug along at the same level for years or even decades and never fail, or it may start failing tomorrow and your TSH will be over the reference range by next month.

    You can look at a graph of "normal" TSH in a healthy population here :

    As you can see, yours is quite high and is above optimal.

    In some countries treatment for hypothyroidism is offered when TSH goes above 2.5. The UK makes people wait for treatment longer than other first world countries.

    In the UK treatment won't be offered by the NHS until your TSH is over the reference range in two separate tests, three months apart, and you have symptoms your doctor recognises as being hypothyroid. Some doctors insist you must have autoimmune hypothyroidism as well i.e. you must have positive antibody tests. If antibody tests are negative then doctors often insist you have to wait until your TSH is over 10 and your Free T4 is under the range.

    One of the effects of hypothyroidism is to reduce stomach acid, and this reduces absorption of vitamins and minerals. Do you ever suffer with indigestion? If you do how do you treat it?

    You need to take iron supplements to improve your ferritin levels. With the reference range you have supplied you would need a level of around 150 (mid-range) to be optimal. You can try ferrous fumarate 210mg. They are high dose iron supplements. You can buy them from some pharmacies without a prescription. (You can also buy them online.) You might have to ask your mother to buy them for you (sorry!) because selling them without prescription is at the pharmacist's discretion. If the pharmacist realises you are young he/she may refuse. You would have to try taking one tablet, 2 or 3 times a day with a vitamin C tablet to aid absorption.

    Iron has a tendency to cause constipation. Vitamin C does the opposite. The idea is to take enough vitamin C to counteract the constipation from the iron.

    The iron to ask for is "Ferrous fumarate 210mg, in a box of 84". This is enough for 28 days at a dosage of three per day (obviously you can take only one or two if you want).

    If you really can't tolerate ferrous fumarate then there are other iron supplements available, but they generally have less iron in them.

    Iron is poisonous in overdose. You shouldn't aim for ferritin levels higher than mid-range, and regular testing is essential. If you start taking iron I would suggest testing after 6 - 8 weeks, don't wait any longer. You might absorb them very quickly, you simply can't tell until you've tried them and been tested a few times.

    If you want to get advice on folate and B12, please join the Pernicious Anaemia Society (PAS) community here :

  • The data for the TSH graph I linked to came from this paper :

    From my point of view the most important data in the paper is the right-hand half of table 3.

  • Thank you very much :)

  • This will be helpful:

    There are other topics on the left-hand side which might be helpful as we need to read and learn unfortunately. If you didn't fast the TSH might have been a bit higher. Your B12 is low and you should supplement with vitamin B12 methylcobalamin sublingual tablets. They dissolve in our mouth or under tongue.

    If you have antibodies you'd have an autoimmune thyroid disease called hashimotos.

  • Thanks

  • Oh jungkookie or

    Lydia as I know you I'm so sorry that you are poorly. But I'm extatic that you have found a doctor who realises FINALLY that you are ill. Despite going to GP twice this week and only seeing a nurse practitioner who was no earthly use at all,twice,then sent home from school. And three weeks ago when GP said you were psychiatric! !!!!!! Not physically ill despit having no phagosites. He sent you to CBT no less. How many thousands will that cost the NHS? Would yoj have the energy to attend?Well they will have to eat their words, glandular fever is not psychological, . The new doctor took 40 mins for your appointment and realises that your June bloodtests were not as normal as Dr psychiatric would have you believe. Tsh of 2.65 and just 4 points into normal for your ferritin is not good. You will get lots of good advice on here. I lurk in the background. @humanbean, @shaws @greygoose will guide you through this. When you're a bit better we will get the blue horizon thyroid + 11 if gp doesn't come up with the goods.

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