Thyroid UK

Vit B12 and other levels


Can someone have a look please...... Thanks

Currently have a FT4 of 31, FT3 4.6 and suppressed TSH (secondary hypothyroidism)

Serum vitamin B12 level 198 ng/L [180.0 - 866.0]

Serum ferritin level 57.9 ug/L [13.0 - 150.0]

Serum folate level 9.8 ng/mL [3.9 - 26.8]Full blood count


Haemoglobin concentration 126 g/L [120.0 - 160.0]

Platelet count - observation 270 10*9/L [150.0 - 400.0]

Red blood cell count 4.33 10*12/L [3.9 - 5.0]

Haematocrit 0.390 L/L [0.36 - 0.44]

Mean cell volume 90.1 fL [77.0 - 98.0]

Mean cell haemoglobin level 29.1 pg [27.3 - 32.6]

Mean cell haemoglobin concentration 323 g/L [316.0 - 349.0]

Neutrophil count 3.87 10*9/L [1.7 - 7.5]

Lymphocyte count 2.15 10*9/L [1.0 - 3.2]

Monocyte count - observation 0.37 10*9/L [0.2 - 0.6]

Eosinophil count - observation 0.17 10*9/L [0.03 - 0.46]

Basophil count 0.03 10*9/L [0.02 - 0.1]

Total white blood count 6.6 10*9/L [3.9 - 11.1]

Serum calcium level 2.40 mmol/L [2.1 - 2.55]


Serum adjusted calcium concentration 2.24 mmol/L [2.1 - 2.55]

Serum inorganic phosphate level 1.44 mmol/L [0.8 - 1.5]

Serum alkaline phosphatase level 50 iu/L [30.0 - 130.0]

Serum total protein level 75 g/L [60.0 - 80.0]

Serum albumin level 49 g/L [35.0 - 50.0]

Serum globulin level 26 g/L [20.0 - 35.0]


Serum sodium level 137 mmol/L [133.0 - 146.0]

Serum potassium level 4.0 mmol/L [3.5 - 5.3]

Serum creatinine level 56 umol/L [44.0 - 80.0]

12 Replies

Could you add full details of Thyroid results with ranges and say what dose Levothyroxine you are on.

Your B12 is low. You could ask for testing for Pernicious Anemia. What are your symptoms - you could ask about this on Pernicious Anemia forum.

Your Potassium is at the low end but in range. If you want to improve this you could eat a banana each day.

Your phosphate level in near the top of the range, you could ask GP about this - is it significant?

1 like

Serum free T3 4.6 (3.1 -6.8)

Serum free T4 31 (12.0 - 22.0)

TSH 0.014 (0.27 - 4.2)

on 225mcg Levothyroxine


What has your doctor/ Endo said about these results - has there been any suggestions?

Your B12 needs attention. Get this checked out as mentioned.


Gp has said nothing, seeing Endo (new referral) on Monday. Gp wouldn't test thyroid antibodies, haven't had antibodies before.

thanks for replying


This T4 is very high

You are probably poor converter due to your low vitamins

You probably do need to reduce your Levo. Maximum drop of 25mcg.

But you need to get low B12 sorted too. You should ask GP to test for Pernicious Anaemia before starting B12 injections

Ask advice on PAS as to how to push for this


Essential to test thyroid antibodies

Also vitamin D - likely too low

Your B12 is extremely low. You will most likely need injections. Definitely testing for Pernicious Anaemia first

Supplementing good vitamin B complex too (don't start till B12 fully tested)

Ferritin is borderline. Eating liver once a week should help improve levels

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Is my B12 low enough to request vitamin B12 injections?

I'm worried i'll be fobbed off.


Yes it definitely is - ask on PAS healthunlocked for advice


Endocrinologist are, in my experience, not remotely interested in any vitamin levels

Ignore that arrogant idiot you saw.

Essential to get your vitamin levels correct.


Have just driven home in tears as have been made to feel like I'm a self-diagnosing google doctor. said Vit12 is completely normal.


Yes I had loads of consultations like that (frequently left in tears. See my profile )

Sounds like he was only Diabetes specialist, certainly clueless about thyroid

You are clearly poor converter.

Taking too much Levo, just increases RT3. It's not the answer

Your FT4 is too high. Obviously if you reduce Levo dose, your FT3 may drop lower.

Getting B12 higher essential. Lots of us supplement sublingual B12 and good vitamin B complex. But your level is so low you really need injections.

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:

Prof Toft - article just published now saying T3 is likely essential for many (probably includes you)

You need to know results of a TPO antibodies and Vitamin D

If TPO antibodies are high (likely) then strictly gluten free diet likely essential

1 like

Suggest you read this article about B vitamins. Perhaps just supplementing yourself is fine


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