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Thyroid UK
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Possible high folate and low vitamin B12

Hi! I've had lots of weight loss, hair loss, and fatigue over the past year. Apparently my thyroid is totally fine. I was, however, diagnosed with anemia and neutropenia. My doctor also ran a B12 and Folate test to see what was up.

According to the lab, my levels technically aren't out of range, but when I'm researching they seem wonky.

Vitamin B12: 347 pg/mL

Folate: 30.9 ng/mL

Also I think my ferritin is nearing the end of the reference range.

Ferritin: 14 ng/mL

Any insight? Thanks!

12 Replies

What was your actual thyroid result? Docs often say fine when not.

Ferritin needs to be at least 70 or mid range for thyroid meds or your own thyroid to work well. Are you on thyroid meds and what thyroid condition have you been diagnosed with?


Thank you for your reply!

TSH: 1.330 [0.360 - 3.700]

- Free T4: 1.35 [0.76 - 1.48]

- Total T3: 93 [60 - 181]

- TSI: 99% [<=122%]

- TSH Receptor Ab: <0.90 [<=1.75]

I haven't been diagnosed with a thyroid condition and I'm not on medication.


Please put the ranges in when you post test results as ranges vary from lab to lab.

Secondly neutropenia can be caused by low iron levels, low vitamin B12/folate levels, any other nutrient deficiency, illnesses, some medication, be genetic or just appear spontaneously.

As your ferritin level is too low you need to sort out your iron levels and ensure you have enough trace nutrients. That may get rid of the neutropenia.

If you think you have a vitamin B12/folate problem it is best to join the pernicious anaemia society on health unlocked as they are the specialists in that area.


Hi sorry about that:

B12: 254-1320

Folate: >5.4

Ferritin: 8-252

My neutropenia seemingly just popped out of nowhere.

Thanks for the reply!


That ferritin range is disgusting. The WHO states anyone with a ferritin level lower than 12 suffers from iron deficiency.


Good to know! I'm seeing a hematologist next week (mostly for the neutropenia). Maybe he can do something about it.


Make sure you ask him.

In other words say politely something like I've been told my ferritin is one and I have high risk of becoming iron deficient anaemic. Is that true?

If he says clearly "No" you know he's a bulllsh**ter and don't push it. If he indicates it depends then ask him if it affects your neutrophil count and ask how you should get your iron level up.


Thanks for the recommendation.

I actually am anemic as well. Can't get my hemoglobin up to normal range. It's not terrible but still low.

I'll be sure to ask those questions.


The lower boundary of many NHS labs ranges is lower than what the WHO guidelines and NICE recommend.

You need 3x iron supplements per day to get that in range. If after 8 weeks your level hasn't gone up you need to see haemotology. They then should ask for you to be investigated why you can't keep your iron up but whether that happens completely depends on your GP and their attitude.

Unfortunately it seems to take people to collapse and be seen via A&E before they get the haemotology treatment they need if they have iron deficiency.

Not having adequate haemoglobin is dangerous. Having low ferritin is a problem but if you don't have enough iron in your red blood cells then you have a worse problem.


I've only been put on a women'smultivitamin with iron (once a day). I am waiting on a hematology consult -- my appointment is on next Tuesday.It's mostly to address my neutropenia, but checking up on the anemia doesn't hurt, either.


you may have an absorption problem - auto-immune gastritis often first presents with iron deficiency B12 actually looks quite good but the thing to watch out for there would be levels dropping over time.

More on B12 on the PAS forum


1 like

Thanks for the information!


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