This is on the low side. According to 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."
Also, this is a Total B12 test which measures B12 both bound to proteins and unbound (free/active B12). We can have a good Total B12 level but a poor Active B12. If you want to test Active B12 then Medichecks do a fingerprick test for £39. Personally I would do the Active B12 test. If it's below 70 then that suggests testing for B12 deficiency. If no B12 deficiency is indicated then you could supplement with a good quality bioavailable B Complex (eg Thorne Basic B or Igennus Super B) and this should raise your B12 level and maintain your folate level.
Serum folate level > 20 ug/L [2.5 - 9999.0]
This is fine.
Serum ferritin level 22 ng/mL [15.0 - 300.0]
Ferritin >15 and <100ng/mL. W - what does it say on the print out next to this?
Even though this is in range, it is low. Ferritin is recommended to be half way though range, yours is just 2.46% through it's range.
Low ferritin can suggest iron deficiency anaemia. You should ask your GP to do a full blood count and an iron panel. He may say it's fine because it's within range, push the fact that it's just 2.46% through range, and if you were at the top of the range he'd still say it was fine but you'd feel very different at that level. If you have any symptoms of low ferritin which are listed below, list these to show your GP.
Thank you for quick reply! I did ask for full iron panel and gp said they dont do that but i will persevere.
My b12 results have gone up since last tested back in Nov by around 150. I starting supplements just a couple of months ago. Could this have improved results and therefore continue improving after more time?
Ferritin >15 and <100ng/mL. W - what does it say on the print out next to this?
It said: With low Hb and MCV,
a normal ferritin in the presence of inflammatory
changes does not exclude iron deficiency.
Only symptoms for low iron is the poor memory/concentration but thought thats cos i was ageing?!
My b12 results have gone up since last tested back in Nov by around 150. I starting supplements just a couple of months ago. Could this have improved results and therefore continue improving after more time?
It could have. What supplements are you taking?
It said: With low Hb and MCV, a normal ferritin in the presence of inflammatory changes does not exclude iron deficiency.
That suggests that if your Ferritin level is between 15 and 100, and your haemoglobin and MCV levels are low, iron deficiency is not excluded if there is a change in your inflammatory markers.
Haemoglobin, MCV and inflammatory markers are part of a full blood count.
Your full blood count seems fine as far as haemoglobin, MCV and inflammatory markers are concerned.
Started Howard and James vit b complex high strength 2 months ago
That supplement doesn't have much to recommend it.
A good B Complex will have, and state, bioavailable ingredients ie methylfolate (not folic acid) and methylcobalamin (not cyanocobalamin). Unfortunately your supplement has these undesirable forms of ingredients.
It also has low doses compared with brands recommended here.
For a very low B12 level you'd want a supplement containing 1000mcg methylcobalamin to start with, then when level has improved, or is at your current level then maybe 400mcg (as in Thorne Basic B Complex).
As soon as it is possible I would change to one of the two brands I suggested above.
Thank you. So in short all ok apart from b12 and ferritin.
As b12 has gone up since supplementing do you think this all needed albeit with a more reputable brand you mentioned? There dont need the other blood test you first recommended.
Re ferritin as rest of blood count ok do you think supplement with iron/eating liver etc or still need iron panel done? I am not sure why my gp doesn't test this, is this usual?!
However, having checked, I have been taking ferrous fumarate 210mg tabs since nov but ferritin results have stayed same at 22. Do i need stronger dose?
Hopefully get thyroid results back today to see if they improved....
Am so annoyed pls see below. tsh has gone up again. It could be because last results blood was drawn in afternoon rather than first thing, could that be why tsh was under 1? Think deffo need another 25mcg increase to 100mcg levo.
Also shows not ovulated again so think will have to start Clomid next cycle.
As b12 has gone up since supplementing do you think this all needed albeit with a more reputable brand you mentioned? There dont need the other blood test you first recommended.
As explained above, Active B12 is a more accurate test than total B12. Personally, I would want the Active B12 test.
Re ferritin as rest of blood count ok do you think supplement with iron/eating liver etc or still need iron panel done? I am not sure why my gp doesn't test this, is this usual?!
You cannot know if you need to supplement with iron tablets unless an iron panel has been done. Your full blood count seems to discount anaemia but you don't know if you have iron deficiency and an iron panel will show this. However, if it comes back with a good level of serum iron then taking iron tablets could increase your serum iron too much and too much iron is as bad as too little iron. Ferritin is not iron. Ferritin is your iron store. If you have a good level of serum iron and a dire ferritin level then your GP should investigate. Your GP
should be able to do an iron panel which includes serum iron, transferrin saturation percentage and Total Iron Binding Capacity. Iron is complicated, I can't tell you any more than that.
However, having checked, I have been taking ferrous fumarate 210mg tabs since nov but ferritin results have stayed same at 22. Do i need stronger dose?
Presumably this is prescribed? Presumably you know why it was prescribed? As your GP why your ferritin level hasn't improved.
The aim of a treated Hypo patient on Levo only is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges. Your TSH is likely to be too high and your FT4 is definitely too low. Your results indicate an increase in Levo would be beneficial.
TSH is highest early morning so we advise testing no later than 9am. Eating can lower TSH. Coffee can affect TSH.
FT4 result is most accurate when last dose of Levo is taken 24 hours before blood draw.
Ok thanks looks like my optimistic result of tsh under 1 and t4 over half was false picture as blood drawn in afternoon Will increase levo from 75mcg to 100. Thanks for all your help.
Hi, just a follow up. Spoke to GP and despite saying all in range, he prescribed iron tablets, b12 and increased levo to 100mcg. B12 is Cyanocobalamin 50mcg, any good?
However, having checked, I have been taking ferrous fumarate 210mg tabs since nov but ferritin results have stayed same at 22. Do i need stronger dose?
so I don't quite understand. However, regular monitoring is needed when taking iron tablets so you should ensure your levels are checked every 3 months (I think that is the normal time frame).
B12 is Cyanocobalamin 50mcg, any good?
I mentioned above that methylcobalamin is the recommended form. It's up to you which you take but as we need a B Complex when taking B12 (to keep all the B vitamins in balance), if it was me I'd not take the cyanocobalamin and just a good B Complex like I recommended - Thorne Basic B, or maybe Igennus Super B.
and increased levo to 100mcg.
That's good, but ensure you are retested in 6-8 weeks time to check your levels, have the blood draw no later than 9am, nothing to eat or drink except water before the blood draw, and take last dose of Levo 24 hours before blood draw.
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pls see below. tsh has gone up again. It could be because last results blood was drawn in afternoon rather than first thing, could that be why tsh was under 1? Think deffo need another 25mcg increase to 100mcg levo.
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