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After consultation with my endo one positive change has been implemented to improve my symptoms - levothyroxine has been increased from 75 to 100mcg. Endo stated: "Your TSH is too high. It needs to be somewhere between 0.5 and 1".

As much as I liked that part I'm not so happy about the response I got about my vitamin/mineral levels which in his opinion are either within its range or just borderline.

Here it goes what was tested:

* TSH - 2.18 mIU/L (0.27 - 4.20)

* FT4 - 16.2 pmol/L (12 - 22)

* FT3 - 4.6 pmol/L (4.0 - 6.8)

* B12 - 297 pg/mL (197 - 771)

* Serum folate - 3.9 ng/mL (2.9 - 26.8)

* Calcium - 2.44 mmol/L (2.2 - 2.6)

* Phosphate - 0.84 mmol/L (0.87 - 1.45)

* Cortisol - 138 nmol/l (133 - 537)

* Iron - 10.9 umol/L (6.6 - 26.0)

* Vit. D - 69 nmol/L (25-120)

Ferritin, reverse T3 and antibodies haven't been tested on this occasion.

Obviously above results aren't optimal but what can be done to improve it?

What supplements should I take and in what amout?

Any suggestions toward particular shop or brand will be very welcomed.

I have posted on Pernicious Anaemia forum an iron panel and full blood count so hopefully they will add something to the pool.

2 Replies

Gr8Nica Unfortunately, doctors aren't taught nutrition so as long as it's somewhere in range, even if only one point up from the buttom, as far as they're concerned then everything is hunky dory.

Serum folate - 3.9 ng/mL (2.9 - 26.8)

B12 - 297 pg/mL (197 - 771)

Your folate is very low and your B12 too low. I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:

"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."

And an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

So if you have no signs of B12 deficiency then you need to raise your level to at least 550 according to that extract, and we always say on here that us hypos need it at the very top of it's range.

If you want over the counter supplements to raise B12 then you should start with 5000mcg sublingual methylcobalamin lozenges, finish the bottle then buy some 1000mcg dose. I used to suggest Solgar but apparently they have gone very expensive. Some people use Jarrows.

A good B Complex containing 400mcg methylfolate will help raise your folate level. Thorne Basic B is often recommended and I used that to raise mine. I now use Metabolics B Complex capsules as they are free from any fillers, they just contain the active ingredients.


Vit. D - 69 nmol/L (25-120)

The recommended level lis 100-150nmol/L according to the Vit D Council.

You could buy some D3 softgels like these and with your level I'd suggest maybe 4000iu daily for 3 months then retest. If you've reached the recommended level you'll need a maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays

There are important cofactors needed when taking D3

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds

Check out the other cofactors too.

For K2-MK7 I'd suggest softgels again, they tend to contain just the vitamin and olive oil, usually no uncessary ingredients. These are good (best value)

Or you could take a D3/K2 combo, there are a few and I take this one

You need to check prices as they constantly change, and Allergy Research and Nutricology are the same.


Calcium is fine, I can't comment on iron as I can only comment on ferritin, and I can't comment on cortisol or phosphate.

1 like

Thank you SeasideSusie. I'll research your suggestions more closely.

In my opinion I have quite substantial signs of B12 deficiency. Which worries me a lot. I think not eating meat and very little fish didn't help that either - I'm a Pescetarian but don't eat as much fish or seafood as I used to.

Also with regards to vit D I usually supplement it during winter but that's not always been the case and I wasn't aware how important it was to have its levels within a certain range.


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