Hi we have strong history of Hashimotos in the family. Recently we had medichecks bloods done for my 18yr old grandson. It showed subclinical hypothyroidism. Our GP ordered all bloods to be repeated by them.
I understand the results except the B12 result.
With Medichecks his active B12 is 66pmol/L range 25.1-165
With Drs surgery his serum B12 is 652ng/L
range 150 -620
I know they are different tests but we thought after medichecks results he might benefit from B12 supplement, as his result was at lower end of range.
Any help will be appreciated.
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Millie103538
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With Medichecks his active B12 is 66pmol/L range 25.1-165
With Drs surgery his serum B12 is 652ng/L
The GP test is Total B12 which measures the total of bound and unbound (free/active) B12 and doesn't differentiate between the two. You can have a good total B12 level but low active B12.
The Medichecks is Active B12 and measures the amount of B12 that is available for the cells to use.
Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:
Reference range:>70. *Between 25-70 referred for MMA
There is a link at the bottom of the page to print off the pdf to show your GP.
I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:
"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."
So you should get your grandson to check if he has any signs of B12 deficiency:
If he does then list them to discuss with his GP and ask for testing for B12 deficiency and Pernicious Anaemia. He 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 he does not have any signs then he could try a B12 supplement along with a good quality, bioavailable B Complex to balance all the B Vitamins.
When I took sublingual B12 I used Cytoplan as it contains methylcobalamin and adenosylcobalamin - two forms of the active B12:
Using on bottle of the B12 may be enough to raise his level, then he can continue with just the B Complex to maintain his level.
For a good B Complex I like Thorne Basic B, it contains methylcobalamin and methylfolate (the recommended forms of those ingredients).
Be aware that any B Complex containing Vit C means that the Vit C will keep the body from using the B12, Vit C should be taken 2 hours away from B12.
When taking B Complex we should leave this off for 7 days before any blood tests as it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).
Sorry for delay in reply slowdragon results above (hope I have done it right) he has started vitamin D3, folic acid and B12 supplements. He has appointment with GP next week.
Hi Susie, no not prescribed. We bought them ourselves.
The doctor did not recheck Vit D bloods even though I said it was low. Go did re check Serum folate which came back normal as 8.8 range 3.10 - 19.9ug/L
He had been taking supplements for 2 weeks, but didn't take any on the morning of the test.
This is Vit D deficiency and GP should have followed guidelines and prescribed loading doses. I don't know what dose D3 your grandson is taking but I suggest that he follows the guidelines himself:
"Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 25 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.
* Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
So that's 300,000iu D3 over 6 weeks, and I would take it on a daily basis so that's 7,000-8,000iu per day for 6 weeks.
When loading doses have been finished he will need to retest.
Initially aim for the level recommended by the Vit D Society and Grassroots Health - 100-150nol/L and when this level has been reached then a maintenance dose will be needed to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. He will have to buy these himself.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.
For Vit K2-MK7 I like Vitabay or Vegavero brands which contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.
Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
Again, this is deficiency and GP should really have prescribed folic acid. I think the normal prescription is for 5mg for a short while - possibly a couple of months, then retest. Aim for at least half way through range, then a B Complex will maintain it.
B Complex information given above, also I gave B12 suggestion above.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If he does have any adverse reaction then he will know what caused it.
Hi I’ve just had a similar result for free B12 mine was 62 but my doc one was okay which was the total B12 so they’ve said I’m ok at the docs and won’t test me again they said . So I don’t know what to do apart from supplement. I have been doing that a year anyway . Let me know what your doc says . Good luck .
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