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Thyroid UK
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Folate issues

I’ve just been started on thyroxine and I decided to pay for a medichecks thyroid screen to get a bit more information than the nhs tests give. It turns out my folate is just at the very bottom of the range despite having been taking folic acid for several years now as part of a multivitamin.

Could it be the hypothyroid causing this or is it the other way round? Has anyone else had a problem with folate despite supplementing?

For quite a while I was taking metafolin but at the moment I’m just having the folic acid in my multivitamin so maybe I should start the metafolin again.

Thanks!

27 Replies
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Which multi-vit are you taking? If it contains iron, that will block all your vitamins, and you won't absorb any of them. As a general rule, multies are a pure waste of money! I wouldn't give them house room.

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Can you post your results for B12 - Folate - Ferritin and VitD ? - also the ranges. If your folate was Low then I am suspecting your B12 will be too - as they work together in an important way in the body .... sorry do not have time to read your earlier posts !

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Active B12 96 (25.1-165)

Folate 4 (2.91-50)

Ferritin 51.6 (13-150)

I take the spray b12 supplement but only occasionally rather than regularly. Maybe a couple of times a month/once a week at most.

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In that case, you would be better off taking a B complex, with at least 400 mcg methylfolate, rather than a multi-vit with folic acid. The Bs all work together, and need to be kept balanced.

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That makes sense. I’ve been on pregnacare breastfeeding version which I mainly wanted for the calcium and iodine because I limit dairy due to lactose intolerance. I suppose I should have a think about what to carry on with.

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You need to know if your hypothyroidism is due to autoimmune thyroid disease diagnosed by high thyroid antibodies (also called Hashimoto's)

Presumably your Medichecks test has tested this. Can you add TSH, FT3 and FT4 results too

If you have Hashimoto's then you probably want to avoid iodine

drknews.com/iodine-and-hash...

thyroidpharmacist.com/artic...

Essential to test vitamin D as well, especially if you have Hashimoto's

How much Levo are you taking?

NHS guidelines saying standard starter dose is 50mcgs

beta.nhs.uk/medicines/levot...

Taking a good quality vitamin B complex with folate in is recommend as this keeps all B vitamins balanced

chriskresser.com/folate-vs-...

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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I’m starting on 25mcg due to heart issues so it’s going to be a bit slower getting to the right dose.

My medichecks showed lots of antibodies so it looks like Hashimoto. Thyroglobulin was 452 ( 0/115) and peroxidase was 250 (0-34).

I’ve stopped the pregnacare already because I read those things about the iodine and the biotin. I was going to ask the doctor about it when I next went in. The first test on the basis of which I was started on thyroxine I had been taking them and the tsh was 7ish. The medichecks one showed as 10.2. I am a bit worried about ending up seeing a different gp and them not being willing to continue to treat me based on private test results. Is that me being silly? I had felt a bit unsure about being treated with a tsh of 7 but now I’ve had a result over 10 and I have all the antibodies I really don’t want the doctors to refuse to offer treatment.

I didn’t get my vit d tested because it was great last time I got tested and I take 6000 units a day because I’m breastfeeding and that’s the amount you need to make sure the milk has enough vitamin d in for the baby. I will probably get it done next time though just to keep an eye on it.

Sorry for the wall of text! It’s a lot to take in when I hadn’t even been even thinking about my thyroid. The test was only done because of my heart issues. Thanks for all the info.

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Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Essential we have good levels of vitamin D, folate, ferritin and B12

As you are breastfeeding this may be post partum thyroiditis or Hashimoto's

The first is temporary version, the second permanent, treatment is the same

Poor gut function can lead to leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

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I think it could have been postpartum because with hindsight I think I was hyperthyroid immediately after the birth. I had so much energy, my house had never been so clean! Plus night sweats and feeling so hot all the time. And then after a few months I had a big slump and piled on a lot of weight all of a sudden and felt terrible. Presumably at a year and a half post delivery if I’m still hypothyroid it’s here to stay?

I’ve been reading about the gluten thing and I am a bit depressed at the thought of giving up gluten but I suppose I ought to give it a try. I will ask about coeliac testing. I’ll have a browse through those links. I’m definitely getting plenty of reading material from you all.

Thanks!

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Just read the article about folate. It’s much clearer than the explanations I’d read before , thanks. I better get myself back on the metafolin.

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Am wondering what your heart issues are ? Some can be caused by LOW T3 - the Active thyroid hormone - also Low Iron and Folate ... :-)

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I’m waiting for some more tests on the heart issue. I had an echo that showed left ventricular dysfunction. Actually my t3 levels were ok. 5.58 (3.1-6.8) which is confusing. Could that mean I actually have enough so don’t need thyroxine after all?

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Mitral valve issues are relatively common with Hashimoto's. This may be linked to your heart issue

Suggest you tell cardiologist that you have Hashimoto's

verywellhealth.com/mitral-v...

webmd.com/heart/news/199911...

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Thanks, yes I will ask the cardiologist. I did wonder if there could be a link but my GP was adamant that it was only if I’d turned out to be hypothyroid that it could be related.

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Why does GP think you are not hypothyroid?

You are clearly hypothyroid, due to Hashimoto's.

Hashimoto's and mitral valve have direct link

Take your Medichecks results in and print out info on mitral valve and Hashimoto's

Also get coeliac testing at same time

Most of us dreaded gluten free, but it's increasingly easy. Eating out is a doddle

Eating at friends or family can be much trickier!

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Sorry I meant if I’d turned out to be hyperthyroid. The gp says I have subclinical hypothyroid based on my first result of tsh of 7ish and offered a trial of thyroxine which I’ve been on nearly a week now. I’m planning on going back after my mri with these test results to try and work out what’s next. Just slightly anxious I might get a different gp who is less willing to let me have the thyroxine.

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With high antibodies and above range TSH, plus symptoms then NHS guidelines say you should be started on levothyroxine

Low vitamins also directly linked to Hashimoto’s

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It's day-light robbery! They shouldn't be allowed to sell things like that! Yes, it contains iron, so you wouldn't be able to absorb any of those vitamins, which is why your folate is still low!

And, as it contains calcium, it will bind with the iron, and you won't be able to absorb either of them! Besides, you don't just find calcium in dairy. Calcium is everywhere, and it's very rare to be calcium deficient with a normal diet. Taking calcium supplements is a very, very bad thing to do.

And, you don't want to take iodine. You are hypo. Iodine is contra-indicated for hypos. Plus it contains copper, and you probably don't want that, either because hypos are usually high in copper and low in zinc. But, I didn't see zinc mentioned…

Put that rubbish in the dustbin, where it belongs! Get your vit D, vit B12, folate and ferritin tested, and supplement what you need, in quantities you need, according to the results. You'll feel much better for it. :)

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I’ve stopped taking them and will definitely follow your advice on thb complex. I had trouble finding a sublingual b complex that was methycobalamin before which is why I went for just the b12 spray. I don’t suppose you could recommend one?

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No reason why you shouldn't continue with the B12 spray, but that is separate from the B complex. You won't find a sublingual B complex, they don't exist.

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Ok, I’ll look for a good b complex then. Thanks for the advice. Starting to feel like I’m getting to grips with it all.

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That's good. :)

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Amazon are good for B Complex - Thorne Research is the one I use :-) next Day Delivery in the UK !

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My personal favourite B complex is Igennus Super B complex. Nice smalltablets, good quality ingredients. Full dose is two per day, can start, or remain in just one a day. Initially B complex best taken in morning after breakfast

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When my Levothyroxine was reduced to 100 from 125

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Sorry as I was saying on 100 Levothyroxine I developed folate deficiency anaemia. Doctors gave me high dose folic acid for 3 months. Then I insisted on an increase in Levothyroxine. Now take B complex daily.

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Some people cannot use folic acid or convert to its active form and so it blocks folate. Try taking methylfolate instead. And if you have other gut problems try for a referral to gastroenterology.

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