Asking for a friend

[Auntbessy]

Hello my friend is trying to get to the bottom of why she feels so tired and has fibromyalgia symptoms. Would someone be able to check her results attached and advise? I have told her that her B12 is low and she could do with upping her levothyroxine slightly.

[SeasideSusie Remembering]

Auntbessy

You are correct about her B12, her result is 250ng/L (which is the same as pg/ml) and 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."

She should also have Folate tested as B12 and Folate work together. However, she should check for signs of B12 deficiency as many people with a level in the 300s have been found to need B12 injections. She can check for signs here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

If she has any then she should list them to discuss with her GP and ask for testing for B12 deficiency and Pernicious Anaemia. She should not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.

If she definitely doesn't have any signs of B12 deficiency then she could take some sublingual B12 lozenges (1000mcg), along with a good quality, bioavailable B Complex to keep all B vitamins in balance. Once the bottle of B12 lozenges has finished, just the B Complex alone should be enough. A good B Complex to consider - Thorne Basic B or Igennus Super B.

She should also test:

Ferritin

Vit D

Her TSH is on the high side for a patient on Levo, most of us feel best when TSH is 1 or below with FT4 and FT3 in the upper part of their ranges. It's important to tet FT4 and FT3 as these are the actual thyroid hormones, TSH is a signal from the pituitary not a thyroid hormone. If she can't get full testing with her GP then she might want to consider a full thyroid/vitamin panel with one of our recommended labs.

[SlowDragon Administrator]

Her GP should run full testing for Pernicious Anaemia before starting any B vitamins

Essential to test folate too

For full Thyroid evaluation she needs 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

Ask GP to test vitamin levels

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 .

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 as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays