Why did my TSH increase on B12 injections?

[Liyaelize]

I had two B12 1000mcg cynocobalimin injections per week for 3 months. My TSH went from under 1 to 6.7. Why would that be? I did not do anything else bar having my T3 and T4 doses 8 hours away from the the B12. Thanks for sharing.

[SlowDragon Administrator]

Because we need GOOD vitamin levels for thyroid hormones to work

Low vitamin levels frequently “hide” hypothyroidism as TSH tends to drop lower when vitamin levels are low

It’s so important to regularly retest vitamin D, folate, ferritin and B12 and maintain all four at OPTIMAL levels

[SlowDragon Administrator]

How much levothyroxine are you currently taking and how much T3

As vitamin levels improve you likely need dose increase

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)

If/when also on T3, make sure to take last third or quarter of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

[Liyaelize in reply to SlowDragon]

Yes. . How I test. My vitamin D levels also dropped a lot after B12 injections. Went from in the forties to 23. I have Celiac as well and wonder if B12 caused an issue. B 12 now high at 1445 range up to 1200

[SlowDragon Administrator in reply to Liyaelize]

Extremely common to need high dose vitamin D when coeliac

Presumably you have Hashimoto’s too

Is vitamin D result in nmol ?

Vitamin D

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Calculator for working out dose you may need to bring level to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Taking too much vitamin D is not a good idea

chriskresser.com/vitamin-d-...

With your Vit D, are you also taking it's important cofactors - magnesium and Vit K2-MK7?

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Gluten free diet is low in magnesium