Vitamins B12,Folate and Ferritin thyroid issues

[D9d9]

Does anyone have some advice on how low levels of B12 and Folate etc affect thyroid hormones? Trying to establish why I feel unwell and why TSH was suppressed 0.02 - while T4 was slightly over range at 21 - top of range 17. T3 was normal and within range.

[humanbean]

T3 was normal and within range.

We will need the result and the range to make any sensible comments on your results. And what was the bottom of the range for Free T4?

[D9d9 in reply to humanbean]

I have put my most recent results up a few days ago..

[SlowDragon Administrator]

Looking at previous posts you are on Carbimazole

TSH often remains suppressed even if Ft4 and ft3 drop too low

If Ft4 and/or Ft3 too low this can lead to low stomach acid and poor nutrient absorption and low vitamin levels as direct result

Low vitamin levels are extremely common with Graves’ disease or Hashimoto’s

Essential to regularly retest vitamin D, folate, ferritin and B12

Frequently necessary to supplement to maintain optimal vitamin levels

[D9d9 in reply to SlowDragon]

I have just stopped Carbimazole as still unwell. T4 was now in range. Asking them to test T3 now. I have been taking a good multivitamin. Just realised I will need to stop multi 7 days before thyroid blood test?So wont take any for now. I also take sublingual B12 as it was too low but maybe need Injected to make sure Im getting adequate.

[SlowDragon Administrator in reply to D9d9]

Did you ever get Graves disease confirmed by testing TSI or Trab antibodies?

[D9d9 in reply to SlowDragon]

The tests they did were all negative. I cant remember which ones they did but they would have been for hyperthyroid I guess.

[SlowDragon Administrator in reply to D9d9]

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

Graves Disease antibodies test.

Requires private blood draw

medichecks.com/products/tsh...

Good info on Graves’ disease

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

healthunlocked.com/thyroidu...

[PurpleNails Administrator]

B12, Folate and other nutrients drop when hyper as they are metabolised quickly and when thyroid hormones are low, things like low stomach acid affect absorption. It’s probably the thyroid affecting the nutrients not the nutrients affecting the thyroid.

From your posts some months ago when you were put on carbimazole due to TSH was suppressed 0.02 - T4 slightly over range at 21 - top of range (7-17) & T3 within range, but what were your recent results?

Did you decided to stop Carbimazole or has your doctor reviewed your test results and confirmed anti thyroid is not necessary. You say you are still unwell…Was the carbimazole causing a reaction. Had it helped your levels into a better range? Without reviewing results it’s not possible to establish if high or low thyroid hormones are causing you to feel unwell.

Multivitamins not recommended, contains ingredients like calcium, iodine, iron. Which do not needed in excess. Most ingredients in too low quantities to be useful and tend to contain the cheapest least absorbable type of nutrient.

High doses of Biotin does need to be stopped 7 days before thyroid blood test. (less for lower doses, but I stick with 7 days for any dose). Ok to take other vitamins.

To know how much B12 you need you need to know your current level.

When you say “The tests they did were all negative. I cant remember which ones they did but they would have been for hyperthyroid I guess.” I’m afraid you can’t assume anything. You simply must obtain the results yourself and check them.

These are the examples of what has happened to me.

1 Doctor does not order the right test. Sometimes they order a basic test first or just one part of a group and if admin view and see it’s not “red flagged” it might never get noticed the incorrect test was ordered.

2 Part of the blood draw wasn’t processed as the blood Haemolysed. Admin look at other results which were in range not noticing not all complete.

3 nurse drew blood in wrong bottle, but other results were ok, so probably not worth telling patient or re-arranging tests to be done.

4 Not all the relevant tests are included even when it’s their idea and after reminding 3 different sets of tests a certain item had not been tested.

5 the lab exclude the requested test or new protocol directs them to test a different item.

6 specialist instructs GP to conduct a certain test (iron panel). GP notes state “system won’t let me request this?” Will do ferritin again as system will allow this.

7 Abnormal results are not abnormal enough for them to bother about. So “patient advised, satisfactory” When neither patient was advised nor results are satisfactory.

8 Abnormal hospital results don’t get followed up or sent to GP and are lost in the system. (My hyper wasn’t diagnosed for another 4 years after this happened). I was not monitored or advised at the time.

[D9d9 in reply to PurpleNails]

Se thyroid peroxidase Ab conc test done on 10/12/2020 came back normal 0.2 U/ml. <9.0

Didnt feel well on Carbomazole. But dont feel well anyway.

My T4 went back into range and TSH raised slightly.

They didnt test T3 which was normal before tablets.

[D9d9 in reply to PurpleNails]

My ferritin is just over 100 and folate was 7 something. I will need to ask for printout of next results for these. Im afraid I didnt have time to stop Biotin before last blood test for thyroid. Theres 14 ug in the multi which is 28% rda. Will this affect results?

[PurpleNails Administrator in reply to D9d9]

Carbimazole only reduces production of new hormone. It doesn’t treat the thyroid issue. Once you stop it,if you are still hyper your levels will rise again. Regular monitoring is important.

thyroid peroxidase Ab tests is for autoimmune thyroiditis (hypothyroid) so that’s not the right test to confirm Graves.

“ferritin is just over 100 and folate was 7 something” you need a print out to get the exact results and range.

“Biotin before last blood test for thyroid. Theres 14 ug in the multi which is 28% rda. Will this affect results?” It’s not a high dose but the reason it’s best to exclude prior to test is because is certain instances it can skew the results and there is no predicting when the testing process will be affected.