So after being on levo for a few months I feel a lot better, however I still get chest pains, headaches, numb/tingly feet/toes and breathlessness. Recent blood test showed, I am deficient in b12. I am a vegetarian, however I do eat cheese (probably more than I should) fortified cereals, Greek yogurt/fortified almond milk, also occasionally fish as well. I am getting another blood test in a few weeks, my doctor stated it’s a antibody test for b12. Can my symptoms be associated with PA? Is there a link between Hashimoto’s and pernicious anemia? Or is it most likely a dietary depletion?
Anyway thanks in advance for any answers 😊
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If serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3
Looking at previous posts you were due retest on thyroid around now
Have you had this done yet?
Which brand of levothyroxine are you currently taking.
Once you work out which brand suits you best, stick on same brand at each prescription
Always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
50mcg levothyroxine is only a starter dose.
guidelines on dose levothyroxine by weight
Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
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.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
Hi SlowDragonThanks for replying, yes my folate, iron/ferritin were all tested, the doctor said all were well within the normal range. Also my thyroid function was tested, and the doctor said it was smack bang in the middle of the healthy range. I am currently on 50mcg of the Mercury pharma brand. I am a fairly small person, so I don’t know if that has any bearing on my levo dose. I am not entirely sure how low b12 was, as I don’t have the actual blood results, just stating what my doctor told me. However I will be filling out the form to get a copy of my latest bloods. Oh and yes I stated to my doctor I am vegetarian, but she still insisted the antibody test. I personally think it will be a dietary depletion, but maybe it’s good to test just in case 🤷♀️
I had assumed any lingering symptoms ie. breathlessness, chest pain, headaches etc.. were possibly due to the low b12. However if I’m still getting symptoms it’s probably hypothyroidism related, you’re probably right. Thanks again
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