How can I convince my GP to test me for Folate and the other key vitamin tests?

How can I convince my GP to test me for Folate and the other key vitamin tests?

I've been hypothyroid for many years and I have dozens of symptoms. GPs keep changing my Levothyroxine dosage but nothing improves my symptoms. They'll tell me to take ferrous fumarate tablets but it upsets my stomach, makes me constipated and keeps me awake at night. I've been taking 2000iu of Vitamin D3/day, Magnesium and Zinc since August. I also had an iron infusion privately in November so my Ferritin levels should have gone up from 19. I lost my job last week due to my symptoms so there's no chance of company medical paying for more private treatment/appointments. The iron infusion was very expensive.

My B12 levels are always elevated and often above range despite me not supplementing B vitamins in the past. However, I really need to have all this retested as my GP last retested these in June 2016 and the Vitamin D3 in December 2014. When I went to see her 3 weeks ago she did not want to test anything.

I keep reading that Vitamin D3, Ferritin, Folate and B12 all need to be optimum. I have never been tested for my Folate levels. I'd never even heard of it before I came to this forum. Does the NHS even test for Folate? How can I convince them to test all these? Is there an official document I can show them to prove they are essential for thyroid health?

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13 Replies

  • Serendipitous,

    Are you sure that folate wasn't tested at the same time as B12? They work synergisticallty so are usually tested together. If B12 was high in June 2016 it is very unlikely to have become deficient in a few months.

    As you had an iron infusion a few weeks ago your iron and ferritin are likely to be very high not deficient.

    Box 1 towards the end of the 2015 BTA Statement on the Management of primary hypothyroidism suggests a number of illnesses including B12 deficiency, folate deficiency, vitamin D deficiency and iron deficiency may be possible causes of persistent symptoms in euthyroid patients on L-T4.

  • Thank you Clutter. My appointment is on Friday and I'll use that document as a reference. I've attached my last test result for B12. It also shows my TSH and Free T4 result. I've checked all of the test result pages again and I can't see any mention of Folate.

  • Serendipitous,

    No folate result there so do ask for it to be tested and for vitD to be retested. I really don't think there is any point in retesting B12, ferritin and iron.

  • Thanks Clutter. Fingers crossed I will get somewhere on Friday.

  • Have you heard of folic acid? If you were to supplement folic acid it would raise your folate. The NHS does test folate (when they want to).

    Having said that folic acid will raise folate, it isn't the best way of supplementing. The best supplement is methylfolate which can be bought either as a separate supplement or as a component of good quality B Complex supplements.

  • Yes I have heard of folic acid, but I don't think I've ever been tested for that either. I think its best I determine what my folate levels are before I start supplementing. Thanks for the link humanbean.

  • People don't get tested for folic acid levels, they get tested for the folate levels that the folic acid increases. :)

    But taking folic acid isn't recommended as a way of raising folate.

  • I asked my GP for Folate and I wasn't even in range. She gave me a course and it just scraped in but I take somecall the time now having gotvit up there myself. The endo put me on D3 as it was very low but it's not always easy to get them on side.

    Your results show you are undermedicated. The bare minimum is that you should be half way up the range so that would be around 14-15 but ideally we would feel better if in the top third or even the top quarter.

    Sadly we don't get a FT3 reading but if your FT4 reading is very low then I would think your FT3 result would be even lower. It would also if an indication of whether you are converting well as well. Remember T4 is only a storage hormone and our body has to convert it to T3, the active hormone that every cell in our body needs to function properly.

    First step would be to ask your GP if you could try a higher dose.

    Are you taking your medication properly as well? In the morning on an empty stomach is probably easiest. Wash it down with a full glass of water so it gets to the right place quickly then nothing more to eat or drink , other than water, for at least an hour. So many thinks stop the thyroid meds working well so no other meds till 2 hours after and calcium, D3, oestrogen iron and PPI's 4 hours after. Fluoride can also be harmful to the thyroid sobi mno longer use fluoride toothpaste or drink tea. Tea is often grown in fluoride rich soils and in the past fluoride was given to people who were over active as a way of slowly destroying the thyroid to get things nearer to normal. At least by doing this you will be giving your meds a chance to work properly.

    When you get tested no medication before the test, your previous dose should be 24 hours before and arrange for your test to be as early as possible and don't eat anything, just drink water. Your GP may tell you you can eat but the TSH will be higher early in the morning as the level changes throughout the day and if you eat that will also make the TSH reading lower which we don't want as the doctor will be saying it's too low so you arextaking too much medication! You don't want that to happen!

  • Interesting that you talk about a higher dose. In March my thyroid results were: Serum TSH 0.05 mIU/L (0.34 - 5.6) and Serum Free T4 14.80 pmol/L (7.5 - 21.1).

    After the above result, my GP decided to lower my Levo from 100mcg to 75mcg.

    The bloods result screen print posted above is 3 months later. I've been on 75mcg ever since. I always take Levo on waking and an hour before food. I've been using an organic fluoride free toothpaste for the last couple of months.

  • I made progress with my GP when I put requests in writing indicating as tactfully as I could that I held her responsible for my ongoing ill-health having discovered that if we are ill as a consequence of a failure by the GP to give us the treatment we need then their surgery is responsible for our costs.

    I have to work hard to be gentle and tactful and to remember that these GPs are struggling with many demands and stresses from all directions.

  • Yes to be fair it can't be easy

  • You will already have been tested for folate, its usually tested with b12 and ferritin as part as a 'tiredness screening'. Some parts of the country won't test vitamin D on the NHS but I think its not too expensive to have it done privately. A local health shop near me will do it for £40. Have you had any general tests done? Like Kidney and Liver tests, blood sugar, electrolytes? It could be worth getting a picture of your general health.

  • My GP agreed to do the tests today. I had to really plead and explain I've lost my job now as a result of my health issues. She still said "Well everybody's Vitamin D is low" but she agreed that something is wrong and my nutrients (Vit D, Folate, Ferritin, B12) and thyroid needs to be screened. GPs can be so frustrating. Thank you everybody.

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