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Thyroid UK
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Antibodies, folate, ferritin, B12 and vit D

Just feel like I am struggling every day and no one understands how I am feeling really unwell with hypothyroid. Awaiting blood results done for repeat thyroid function test a week ago. Have so many questions and don't know where to start.

Heavy periods since age 13, recent weight gain, tiredness every day, feeling cold but sweating, acid reflux, losing hair, breathlessness. Feel like giving up with this illness at times.

Ferritin 45 (30 - 400)

Folate 1.9 (2.5 - 19.5)

Vitamin B12 227 (190 - 900)

Vitamin D total 25.6

Thyroid peroxidase antibody 504 (<34)

Taking iron and vitamin D.


7 Replies

How long have you been supplementing iron and vit D for and how much? What about your low B12 and folate? What has the GP said and done about it?

You could post your B12 and folate result on the HealthUnlocked Pernicious Anaemia forum and get advice. Do you have symptoms of B12 deficiency?


B12 is best top of range and all other vitamins need to be mid-range. Ferritin needs to be at least 70 for levothyroxine to work well.


Iron - 1 tablet since Feb 2017, was on 3 tablets a day from 2013 - 2016

Vitamin D - 800iu since 2014

Folate - GP prescribed folic acid 5mg

B12 - told in range despite symptoms of B12 deficiency

Results done a month ago



These are dire

See SeasideSusie detailed vitamin supplements advice



Plus your high antibodies confirms you have autoimmune thyroid disease also called Hashimoto's

With Hashimoto's it is very likely hidden food intolerances can be causing issues, most common by far is gluten.

Changing to a strictly gluten free diet may help reduce symptoms. Very, very many of us here find it really helps and can slowly lower antibodies.








Ferritin 45 (30 - 400)

1 tablet since Feb 2017, was on 3 tablets a day from 2013 - 2016

To have been taking 3 x iron tablets daily I assume you had a diagnosis of iron deficiency anaemia? Has this been monitored? Recent results for MCV/MCHC?

For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. With your level being s low in it's range, I would ask for your prescription to be raised to 2 x iron tablets daily.

Also, you can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

Take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.


Folate 1.9 (2.5 - 19.5)

Vitamin B12 227 (190 - 900)

Folate - GP prescribed folic acid 5mg symptoms of B12 deficiency

You really need to post these results on the Pernicious Anaemia Society forum for further advice as you have symptoms of B12 deficiency. They are the experts and you can then discuss their advice with your GP. If you have symptoms of B12 deficiency I imagine they will confirm you need B12 injections and they will advise the way forward.


Most members, for some reason, don't bother posting on the PA forum when advised to do so, as you have symptoms of deficiency then I hope you will.


Vitamin D total 25.6 Vitamin D - 800iu since 2014

A question to ask your GP:

"As I have been taking a Vit D supplement for 3 years, why am I still just 0.6 away from severe deficiency?"

800iu D3 isn't going to ever raise your level. It is hardly a maintenance dose for someone with a reasonable level.

NICE treatment summary for Vit D deficiency:


Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.

For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the guidelines and prescribes the loading doses. Once these have been completed you will need a reduced amount (not a paltlry 800iu) to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and then 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 vitamindtest.org.uk/

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.


Thyroid peroxidase antibody 504 (<34)

Your high antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Gluten/thyroid connection: chriskresser.com/the-gluten...






Hashi's and gut/absorption problems go hand in hand, and are most likely behind the cause of your dire nutrient levels, I'm sure SlowDragon will come along and give further information and links to help.

PS - ha ha, SlowDragon beat me to it!


Yes monitored for iron deficiency due to MCV being below range and MCHC being above range. Recent results

MCV 76.9 (80 - 100)

MCHC 387 (310 - 360)


So these results are suggesting that you are still iron deficient. Surely your doctor should be addressing this, and 1 x iron tablet a day is not enough, I would ask for appropriate treatment.


Posted on pernicious anaemia forum as well, hope to get response soon

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