Will B12, Ferritin, Folate levels rise on higher dose Levo?

[ds_charles]

I've been diagnosed with Hashimoto's for the last 9 years and I just had my latest blood test results back. As you can see, with high TSH and low FT3, I'm probably on too low a dose of Levothyroxine (currently 100mcg). Fingers crossed that FT3 will rise once I'm on 125mcg and I'll feel better. Current symptoms include: poor sleep, dizziness, low heart rate, fatigue.

My question is: Should I also supplement with B12, Ferritin and Folic Acid to bring those values up, or will they balance out once I'm on a higher dose of Levo?

Thanks for your help!

David

ENDOCRINOLOGY

Thyroid Function

THYROID STIMULATING HORMONE *5.98 mIU/L 0.27 - 4.20

FREE THYROXINE 16.74 pmol/L 12.00 - 22.00

TOTAL THYROXINE(T4) 83.0 nmol/L 59.00 - 154.00

FREE T3 *3.04 pmol/L 3.10 - 6.80

Thyroid Antibodies

THYROGLOBULIN ANTIBODY 66.900 IU/mL 0.00 - 115.00

THYROID PEROXIDASE ANTIBODIES*121.1 IU/mL 0.00 - 34.00

HAEMATOLOGY

Vitamins

VITAMIN B12 232 pmol/L 140.00 - 724.00

FOLATE (SERUM) 19.98 ug/L 2.91 - 50.00

BIOCHEMISTRY

Inflammation Markers

CRP - HIGH SENSITIVITY 0.0 mg/l 0.00 - 5.00

Iron Status

FERRITIN 145.6 ug/L 30.00 - 400.00

[greygoose]

I doubt a rise of 25 mcg levo is going to have much impact on your FT3, because you just aren't converting it very well. To get enough T3, you would need to have your FT4 well over-range. And, you really don't want to have that much unconverted T4 slopping around. You need T3. Whether or not you will get it is another question.

I suppose there is a chance that your nutrient levels will rise when - if - your FT3 level rises, but then again, unless your nutrients are optimal, it's doubtful your body will be able to use that hormone, anyway. In fact, your lack of conversion could be down to low nutrients. Although your folate is good, and your vit D3 hasn't been tested.

Why not try raising your B12 a bit, first. You want it over 500. Try taking 5000 mcg sublingual methylcobalamin (B12) daily. When you've finished the bottle, get 1000 mcg as a daily maintenance dose. And, with that, take a B complex to balance the Bs.

[ds_charles in reply to greygoose]

Wow- thanks! Is this from your own personal experience or research? I'd love the references if you've got them to hand - I have so much to learn! (Only 9 years late!)

I'd heard that B12 oral supplements weren't much use because, while they elevate total B12, they don't necessarily raise active B12 that your body can use. I was going to try and convince my doctor that I might need to have shots.

I'll ask him about T3 as well - any advice on how to convince GPs would be very welcome! I've got Dr Toft's book so will be using that, but any other ammo would come in very handy.

Fingers crossed! Thanks again.

David

[greygoose in reply to ds_charles]

Well, a mixture of both, really. I, too, convert badly, and am on T3 only - which I buy myself. Although, to be honest, I could get it from my doctor, because I live in France, and T3 only costs a few euros a box, so there's none of hoo-ha you get in England about prescribing T3. The only thing is, they still don't understand that if I'm going to take the dose of T3 I need to make me well (or less sick) is going to suppress my TSH, and they get scared. So, I got fed up with the monthly struggle to keep my dose as it is, with my suppressed TSH, and started to self-treat. So much easier!

If you want to know more about B12 - because I'm no expert! - pop over to the Pernicious Anemia forum on HU, and do some reading, ask some questions. They know all about it. But, it is rather doubtful that your doctor will give you injections with that result; whilst low, it's not low enough for them to take notice.

But, what I do know is that I was having terrible neurological problems - I was losing the use of my right arm, I had trouble keeping my head still on my neck, it wobbled around, I was like a noddy dog in the back of a car! - and when tested, my B12 was about 350, which my doctor pronounced 'perfect'! Silly old fool. So, I started taking 5000 mcg sublingual methylcobalamin, anyway, and gradually, the arm and head got better, and now are back to normal again. But, I've still got bad peripheral neuropathy. That is for life, I'm afraid. So, do check it out.

[ds_charles in reply to greygoose]

Interesting stuff. Sorry to hear about your noddy dog!

How did you calculate how much T3 to take? Or was it a slow process of calibration?

Re B12, I'm going to start eating liver every week and see if that makes an impact. I'd like to keep supplementation to a minimum, but I'll keep a close eye on it and if nothing changes I'll supplement as you suggest.

Thanks again!

d

[greygoose in reply to ds_charles]

With hormones, you always start low, and increase slowly. But, I wasn't starting from scratch. Previous to that, I had been on NDT, so was used to taking T3.

I'm not sure eating liver will have an effect on your B12, but it should do wonders for your ferritin.

[ds_charles in reply to greygoose]

I don't suppose there's a protocol anywhere online for self-medicaters of T4/T3? It's not something I'll jump into, but it'd be good to bear in mind if things don't go to plan with my GP.

Thanks!

d

[greygoose in reply to ds_charles]

I don't know of one. But, I would say, as you're on 100 mcg levo at the moment, introduce 6.25 mcg T3, and hold it for two weeks. Then, add another 6.25 mcg, and wait another two weeks. Carry on like that until you reach 25 mcg, and hold for six weeks, then test.

[ds_charles in reply to greygoose]

Thanks!

[greygoose in reply to ds_charles]

You're welcome.

[SeasideSusie Remembering in reply to ds_charles]

I eat liver once a week which has raised my pretty dire ferritin to a good level now. It's classed as a 'superfood' and according to the chart here, 100g of beef liver contains 111.3mcg B12 so you'd have to eat an awful lot of liver to raise your B12. My reading tells me that liver should be kept to a maximum of 200g a week due to the high Vit A content.

chriskresser.com/natures-mo...

[ds_charles in reply to SeasideSusie]

Thanks Susie!

I'll keep taking bloods and monitor the situation. Do you have problems with low B12? If so, I'd love to hear your solution or process.

All the best (the support on here is great, isn't it?!)

d

[SeasideSusie Remembering in reply to ds_charles]

No Charles, that's the only nutrient that was at a reasonable level when I tested at first. It was in the 600s but as it's generally said that we Hypos need it at the very top of the range, even 900-1000, I do supplement with sublingual methylcobalamin lozenges 1000mcg 3 times a week which keeps it nearer the 1000 mark.

[ds_charles in reply to SeasideSusie]

Great! Did that help with your symptoms?

[SeasideSusie Remembering in reply to ds_charles]

Charles, I was so unwell I have no idea what was causing any of the symptoms.

Testing showed severe vitamin D deficiency, bottom of range folate and ferritin, low zinc, low adrenal reserve (practioner diagnosed from results), rock bottom sex hormones, poor conversion of T4 to T3 and subsequent testing showed high rT3, so it's not possible to pinpoint anything.

I can only say I didn't have any of the problems listed for B12 deficiency that couldn't be linked to anything else. I only take the B12 supplement to keep my level right up.

[ds_charles in reply to SeasideSusie]

Crikey! Sorry to hear that. Sounds like I'm getting off pretty easy. Hope you're doing better now. All the best,

David

[jgelliss in reply to greygoose]

WOW !!!! What a story grey goose . I'm so happy for you that it worked out at the end for you . And your back to yourself . GOOD FOR YOU .....

[greygoose in reply to jgelliss]

Thank you. Yes, it was quite scary.

[jgelliss in reply to greygoose]

I'm sure it must have been extremely frightening . Human nature always thinks of the worst .

[mimimo in reply to ds_charles]

Do the B-12 sublingual...B-12 is almost impossible to get out of the stomach...under the tongue goes into the blood stream and bypasses the stomach

[ds_charles in reply to mimimo]

Thanks! I've got myself a nasal spray that I'll start using after seeing the GP tomorrow. Fingers crossed!

[Taz12 in reply to greygoose]

Hi, could you please tell me where I can buy T3 from? I am taking 100mcgr of Levo, but I ve just asked my Doctor to increase as my levels where low. She put it up by 25 every other day. I also have vitamin B12 deficiency and low folate. So I get an injection every 10 weeks for B12 and now take folic acid 5mg a day. Been taking for 3 months now, But I feel so poorly. my appetite is poor but I'm putting on weight and can not seem to shift it. I would be great full for any help with getting T3 I've asked my doctor but yet again the answer is not!

Regards Taz12.

[greygoose in reply to Taz12]

Taz, you need to post your own question, asking people to PM you links to where you can buy it. We can't discuss it on the open forum. Sorry.

[ChronicTonic]

All very useful reading (this is me too!).

Stocked up on vitamins just yesterday for Ferritin, B12 and Folate. Liver meal incoming (and yes, also being careful of Vit A)

Many thanks all, and good luck Charles.

[ds_charles in reply to ChronicTonic]

Thanks! I don't know what your situation is exactly, but I'm not going to supplement until I've got as much from my GP as I possibly can. Although I feel pretty rotten, I think it's worth waiting just another week before giving up totally! Better to have them onside than going alone and paying for everything myself.

Supplementing now would confound any extra blood tests I might need and perhaps put my GP off from prescribing b12.

Good luck!

[ChronicTonic in reply to ds_charles]

Absolutely. My GP already has my full NHS bloods from June, and my email this week pointing out what's what (that he didn't notice!) and I'm just waiting for him for to get back to me with a prescription, as h doesn't work every day. That's If he ever talks to me again, lol!

In the meantime I bought the absolute smallest pots of everything needed and have begun taking them according to the advice of my nutritionist friend who pointed out the issues with my blood levels in the first place (while the GP just scanned them and read 'normal normal normal')!

Hope it all goes well your end.

Abi.

PS; it was pointed out to me that it's #thyroidthursday on Medichecks website which means a discount on some of their thyroid tests today.

There's also a 20% discount til the end of the month, with the code advertised on their Facebook page.

My TSH levels were fine, my GP agreed to check my T4 level (I'm currently waiting for that result) but he wouldn't do the T3.

You may be in a similar situation and find Medichecks handy (it was suggested to me by one of the lovely people on here).

[ds_charles in reply to ChronicTonic]

Nice one! I used Medichecks for my latest and am going into the doctor's tomorrow to hear about some I had done through the NHS. Let's hope they corroborate each other! Thanks for the 20% off tip - I didn't know about that.

d

[Polaris]

Your B12 appears quite low and, as you probably already know, is often connected with Hashimoto's, with some symptoms overlapping.

Before supplementing, it would be a good idea to read these links:

b12deficiency.info/signs-an...

LAtest BMJ research document:

cmim.org/pdf2014/funcion.ph...

[ds_charles in reply to Polaris]

Thanks Polaris - that's super useful!

[jgelliss]

ds_charles if you are not a good converter you should try to be on Selenium helps with conversion .