Thyroid UK

Results for vitamins/minerals

As suggested here are results for vitamins/minerals for ongoing symptoms. I was meant to be rechecked 2 months ago. GP could not fit me in for blood tests. I am currently feeling pretty awful. I do take folic acid but since taking this I have been getting pins and needles in my feet, hands and fingers. Feet have also been getting colder since taking it but because these symptoms happened after the under medicated ones I can't be 100% sure what is causing these problems.

Thank you

FOLATE 1.87 (2.5 - 19.5)


VITAMIN B12 191 (180 - 900)


8 Replies

I hope somebody else can confirm, but if you have low folate and low vitamin B12 then supplementing folate before vitamin B12 can make your low B12 symptoms much worse. So, I think you should stop supplementing the folic acid and should start supplementing vitamin B12 pronto. After you've been on B12 for a while then you can restart the folic acid.

To confirm what I've just said please ask the Pernicious Anaemia Society people about this. You can find their community here and you have to follow it the same way you do the Thyroid UK forum :


the big problem with being treated for a folate deficiency in preference when there could be a b12 deficiency is that high folate levels can mask the effects of B12 deficiency in the blood, meaning that the B12 deficiency continues and the neurological effects are untreated for so long that they become irreversible. There is also a risk of Sub-accute degeneration of the spinal chord if a folate deficiency is treated without treating a B12 deficiency that exists at the same time - so the recommendation is to start B12 treatment 24-48 hours before starting to treat the folate deficiency. If both are present then after this period both need to be treated as the body can't use B12 properly without folate/folic acid.


Your second link is saying what I was trying to say. :)

"a 2007 study demonstrated cognitive impairment in patients with high folate status in the presence of low B12. "

"The authors suggest that excess folic acid precipitates both hematologic and neuropsychiatric manifestations of B12 deficiency. Interestingly, folic acid conferred cognitive protection in the presence of normal B12 levels. The point here is that folic acid supplementation in the presence of B12 deficiency may actually aggravate neurological symptoms."


Emerald22 - Eljii has given the optimal levels of vitamins and minerals in her post. You can see that you are a very long way from optimal.

For ferritin, please discuss your results with your GP, you may need iron infusions. As it is under range, ask for a full iron panel to see if anything else is going on. A minimum of 70 is needed for thyroid hormone to work properly, half way through range is recommended and I've seen it said that for females it should be 100-130. A good way of helping to raise ferritin is to eat liver once a week, either as a complete meal or in something like cottage pie, casserole, bolognese sauce, curry, liver pate.

For B12 and Folate, which work together, HumanBean has given the link to the Pernicious Anaemia Society forum. So pop along and get their advice. Then go and see your GP and ask to be tested for Pernicious Anaemia. You may need B12 injections. Anything under 500 can cause neurological problems, recommended level is very top of the range, even 900-1000. Don't supplement until you've taken further advice.

Your Vit D level is poor, recommended level is 100-150nmol. You should supplement with D3 (my choice is softgels) and I would take 10,000iu daily for 3-4 weeks, then 5000iu daily throughout the rest of the winter. Re-test in the spring and if you've reached the recommended level reduce dose to 5000iu alternate days.

When taking Vit D we also need it's important co-factors K2-MK7 and magnesium -

Vit D aids absorption of calcium from food and K2 directs the calcium to bones and teeth rather than arteries and soft tissues. D3 and K2 are fat soluble so should be taken with the fattiest meal of the day.

Magnesium comes in different forms, check here to see which would suit you best and as it is calming it's best taken in the evening -


Look into a gluten free diet, being short in the nutrients you are could be symptomatic of gluten sensitivity and damage to your gut.

Don't wait to supplement B12. Get some sublingual methylcobalamin (under the tongue) and take 2-3 mg a day. Irs very dangerous to the brain and nervous system to be deficient. In time, you may find that you need either adenosyl or hydroxocobalamin, and you may need shots, but this would be a good start. stay away from cyanocobalamin - it hasn't cyanide molecule your body needs to detox, which creates more stress on your body.

Pause on the folic acid while starting the B12. Wait a few days. Then try 400-800 mcg of 5-methyltetrahydrofolate, the most active form of folate. Folic acid can build to toxic levels in some people. If you feel weepy or depressed, you might need more.

You may also need cofactors like magnesium. B6, or B2. A Genova Diagnostics NutrEval test may be helpful in coming up with the best plan for you. Their website has a sample test.

Do talk to your GP about this. You have some serious deficiencies and will likely feel much better once they're addressed.


Your B12 is low, and I think it is possible you will need injections. If you begin to supplement it yourself it will skew any future blood testing by your doctor. You really need to get those bloods re-tested as soon as possible. I have injections for low B12, and before I was diagnosed I felt terrible. I think the folic acid may be worsening the B12 symptoms, as pins and needles, numbness, feeling cold indicate that.

Have a look at the Pernicious Anaemia Society website, you can download a full symptom list from there. If you tick all that apply to you, take that along to your GP, then push for those blood tests.

I hope you will get treated soon. Best wishes MariLiz


given that you have low folate, B12, VitD and low ferritin points to an absorption problem - which could be a lowering of stomach acidity. The symptoms of low stomach acidity are pretty much the same as high stomach acidity so it is often mistreated making the absorption problems worse.

ferritin is a protein that binds to iron so the body can use it - low levels can indicate low iron levels but to confirm this your GP needs to look at other indicators - such as a full blood count.

On B12 I would recommend that you look at the PAS forum on health unlocked

you also need to make sure that your GP is aware that serum B12 is a test that

a) requires evaluation in light of symptoms - you can't just use the test score as an evaluation tool - the range is set such that around 35% of people who are suffering from the effects of B12 deficiency are not caught by the range .... and about 10% of those who aren't are caught by the range.

b) there are some other tests that can help clarify B12 - MMA and homocysteine (though homocysteine is going to be affected by the fact that your folate level is deficient.

c) despite the link to anaemia in relation guidelines etc around B12 deficiency around 30% of people present with neurological symptoms before any anaemia actually shows up in blood work. The fact that you are also iron deficient is going to work towards smaller red blood cells where as B12 and folate deficiencies tend to larger red blood cells - so they should not dismiss the possibility of a B12 deficiency just because there isn't any sign of macrocytosis in a full blood count

d) there are two regimes for treating B12 deficiency caused by an absorption problem - and you seem to have neurological symptoms so should be following the more generous regime - which is loading shots 3xweek until symptoms stop improving (review at 3 weeks) followed by maintenance every 2 months. If there isn't neurological involvement its 3xweek for 2 weeks followed by 3 monthly shots.

However, people vary a lot in how they metabolise B12 from shots and many people find that they need maintenance more frequently. Once treatment has started serum B12 tests are no guide at all unless they come back low.

Really hope that you are able to work with your GP on this one.


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