Kidneys thyroid and b12

[Sark1]

I finaly got a glimpse of my test results and notice that B12 is 250_should I be seeking to improve that and Can I safely take B12 with a kidney gfr of 38 thanks

[BadHare]

Eek! That’s low. Do you have deficiency symptoms?

I don’t know about the impact on kidney gfr, but you might have a big improvement in your general health from increasing B12 (opt for methycobalamin). Don’t forget you need folate too so eat lots of fruit & vegetables, &/or take a good B complex. If your levels remain low because there’s an absorption issue, try adding some lemon juice or apple cider vinegar to water to take meds, supplements & before meals, try sublingual methycobalamin, or consider injecting which will definitely help.

[Sark1 in reply to BadHare]

Thank you. I am stabilised around that number for 2 years! have been trying for most of that time to get gp to inject Have not had the courage to try sublingual for fear of adverse effect on Kidneys

[BadHare in reply to Sark1]

I'm afraid I know nothing re GFR & kidney issues with this regard.

Perhaps post your question on the PA (Pernicious Anaemia) HU forum. The clever folks on there may be able to give you specific help.

Another place to ask for help is this B12 charity: b12d.org/

[BadHare in reply to Sark1]

Best to check with the B12 charity but this was on their information page:

Should I begin treatment straight away?

You have a short window of opportunity, between diagnosing B12 deficiency, and the damage becoming permanent.

Once you have been diagnosed with B12 deficiency, there is no reason to hold off taking treatment. The only reason to hold off getting treatment is if you're still waiting for a diagnosis. Once you begin to take additional B12, then it is difficult to do a blood test and get a confirmation of B12 deficiency. Of course, if your doctor has already taken a blood sample for the tests, then you can begin taking B12 straightaway.

B12 is a food substance, and there are no side effects from taking it. If it turns out that you are not B12 deficient, then your doctor will need to give your other treatment. But it won't have done any harm if you have already started taking B12.

If you want to know about the medical literature that supports this, then please check out BMJ Best Practice (this is the section on the British Medical Journal web site where they summarise all of the research so that a busy doctor can take a subject in). It's a subscription only web site and restricted to medical professionals, but you could ask your GP to print off the relevant section to let you read it.

BMJ says

diagnose on the basis of symptoms. Blood serum level is not a reliable test so include it as one of the symptoms

start treatment if you have any suspicion of B12 deficiency. It does no harm and doesn't interfere with any medical treatment, whereas delaying could cause problems. Vitamin B12 is likely to improve the patient's mood so that will help with every dis-ease

tailor treatment to the needs of the patient. If they need frequent (alternate days, daily) injections then give them these injections. minimise symptoms

injections can be given by a nurse, HCA or by the patient at home, with a bit of training. Review every 6 months.

[Sark1 in reply to BadHare]

Thank you for your help. I have taken your suggestion on board!

[BadHare in reply to Sark1]

You’re welcome!

[SlowDragon Administrator]

How much levothyroxine are you currently taking?

What are recent results?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Your B12 is VERY low

GP MUST test for Pernicious Anaemia and you may need B12 injections

Ask GP to test vitamin levels and thyroid antibodies if not tested

What are folate, vitamin D and Ferritin results?

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Low GFR can be linked to being hypothyroid

ncbi.nlm.nih.gov/pmc/articl...

academic.oup.com/jcem/artic...

[Sark1 in reply to SlowDragon]

Thank you for your comprehensive reply

[Sark1 in reply to Sark1]

My latest TAG =1.11. I AM TAKING 75 Levothyroxine

Not Tiva

[SlowDragon Administrator in reply to Sark1]

75mcg is only one step up from starter dose of levothyroxine

What are your most recent TSH, Ft4, Ft3 results and ranges

TAG? Did you mean a TSH?

Just testing TSH is completely inadequate

Essential to test vitamin D, folate, ferritin and B12 regularly too

NICE guidelines

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

Post re how to push for dose increase in levothyroxine

healthunlocked.com/thyroidu....

[userotc]

I think you should be aware of possible kidney issues with high doses of b12 where there is existing kidney disease ukidney.com/news/nephrology...

Technically my mum has kidney disease with an egfr of ~45 so must be careful what she takes (I can send a link re all supplements to avoid). Her serum b12 was ~400 in last test.

[Sark1 in reply to userotc]

Thank you

[MichelleHarris]

Hi Sark1, Can I just ask, my B12 is 113 pmol/L and medichecks says thats normal. Is yours a different range please ? x

[helvella Administrator in reply to MichelleHarris]

For 113 to be an OK result that would have to be an Active B12 test which has completely different ranges to the serum B12 test. That is, a different test.

[MichelleHarris in reply to helvella]

Thank you x