Vit b12 advice please

[RoboTh]

Just had my results 12 weeks after starting levo 25mcg 6 weeks 50mcg 6 weeks and just started 75mcg

No ranges as yet will post when I have print out . Fasted early morning bloods

TSH 4.78

Folate 19.6

Ferritin 15

Serum b12 390

I have a chronic ferritin deficiency, had annual iron infusions but not sure they'll give me any more (needs to below 10 for them to consider)

I was about to order ingennus super vit b complex but it has Vit c in it and I believe it's not supposed to be taken with Vit c....any alternatives and if I take my levo @4am and ppi at 8 what time do I take vit b supplement?

T.i.a x will do a vit d test privately at some point

[Lalatoot]

Robo re ppi. Hypo folks tend to have low stomach acid. The symptoms for low and high stomach acid are very similar. Drs don't tend to realise this.If you are not getting symptom relief with your ppi then I suggest your stomach acid is already low.

[RoboTh in reply to Lalatoot]

I can't even miss one dose of ppi been on them for 20 yrs. Literally can't manage without x

[Lalatoot in reply to RoboTh]

Tat's ok then. It makes some hypos stomach probs worse so always worth a mention.

[SeasideSusie Remembering]

RoboTh

Vit C should be taken 2 hours away from B12.

I like Thorne Basic B for my B Complex, one capsule gives 400mcg of methylcobalamin and 400mcg methylfolate.

B Complex should be taken no later than lunchtime as it can be stimulating so we don't want it to stimulate us later in the day and disturb sleep. All supplements should be taken 2 hours away from thyroid meds, with a few needing 4 hours, eg iron, calcium, Vit D magnesium.

[SlowDragon Administrator]

As your dose levothyroxine is increased and vitamin levels improved you should be able to slowly reduce and stop PPI

PPI must be absolute minimum of 4 hours away from levothyroxine

You can take levothyroxine at bedtime. Often more convenient and can be more effective

Low stomach acid can be a common hypothyroid issue

The fact you have been on ppi 20 years suggests you may have been hypothyroid a very long time

Thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

Web links re low stomach acid and reflux and hypothyroidism

nutritionjersey.com/high-or...

articles.mercola.com/sites/...

thyroidpharmacist.com/artic...

stopthethyroidmadness.com/s...

How to test stomach acid

healthygut.com/articles/3-t...

naturalendocrinesolutions.c...

meraki-nutrition.co.uk/indi...

huffingtonpost.co.uk/laura-...

lispine.com/blog/10-telling...

Protect your teeth if using ACV with mother

healthunlocked.com/thyroidu...

Ppi

Omeprazole will lower vitamin levels even further

gov.uk/drug-safety-update/p...

webmd.com/heartburn-gerd/ne...

pharmacytimes.com/publicati...

PPI and increased risk T2 diabetes

gut.bmj.com/content/early/2...

[McPammy]

Your TSH is way too high. It needs to be around 1.00. A healthy thyroid is at this level. NHS ranges are set too wide. This was explained to me by my private Endocrinologist. You will feel lots of hypothyroidism symptoms until your TSH is brought down to about 1.00. Hopefully your Levothyroxine increase will bring your TSH to a better level. Try snd request you have your T4 and T3 checked too.

[RoboTh in reply to McPammy]

Thanks. Blood check again in 6 weeks and dose increase. They won't check T4 I'll check that privately once on 100 mcg 😉

[RoboTh in reply to McPammy]

Will my TSH come down quicker in the next 6-12 weeks now dose is getting bigger 75mcg or does it just steadily decrease. Desperate to start losing the excess weight 1stone I've never been this big x

[tattybogle in reply to RoboTh]

There no 'usual' when it comes to speed of TSH lowering. I've seen results on here where it drops massively in a few weeks, whereas mine dropped from 6.8 to 2.9 after 7 weeks on 50mcg , then stayed at 2.5/2.7 on 100mcg and even 150 mcg for about a year and a half , then fell through the floor to 0.001 when i took about 175mcg.

It's a case of 'suck it and see' i'm afraid .

[RoboTh in reply to tattybogle]

Every time I increase my dose including when I initially started I feel absolutely hyper for several days up to a week, then it wears off and once I get to the three week mark start to go back downhill. It's this normal. Also just started with breast tenderness++++ as if some hormones are waking up. I used to suffer with this years ago on and off with periods x

[tattybogle in reply to RoboTh]

Yes,it is quite usual to have that 'wearing off' effect after a few weeks. and the 'too much at first' feeling doesn't surprise me in your case. Your body must have been used to having 'not enough' for a very long time , while your TSH was creeping up to 10.. so it will be having to get used to going a bit faster each time you increase. but hopefully these too much / wearing off effects will be come less as you get nearer to the right dose.

But with TSH 4 ish it looks like you are still quite a long way off being on the right dose.

I think these ups and downs are the effect of TSH noticing the higher level of T4 ,so TSH lowers a bit then your own thyroid makes a bit less., then TSH notices again and maybe goes up a bit , and this sort of thing continues till everything settles down and after 6+ weeks the TSH is hopefully at a level where it stays put. That's just my theory , because we never get TSH tested every day during the first few weeks of an increase so i don't know if it really does go up and down like this.. but there's a lot of complex rebalancing to be done when we change dose, and this will no doubt affect the deiodinases that are responsible for adjusting how much T3 you are getting.. so it's no surprise we feel too fast then slower again.

As for the breast tenderness .. thyroid hormones go to nearly every cell/system in the body . TSH is affected by the time in menstrual cycle, so yes , your theory about breast tenderness is perfectly possible too ....see this healthunlocked.com/thyroidu... do-tsh-levels-naturally-increase-during-menstruation

[RoboTh in reply to tattybogle]

Thanks for replying, it's v.helpful. steep learning curve x

[McPammy in reply to RoboTh]

It’ll only decrease when you are on your correct dose and if you are converting well of T4 Levothyroxine to active T3. Also your weight will start to slowly drop when your TSH is good. Good is about a TSH of 1.00. That’s what it is for a person with a healthy thyroid. Also you need to try and get your vitamins all optimal not scrapping in at the bottom of ranges.