Serum folate + thyroid results

[anitajeanwebb]

Hello I was just wondering if anyone else has had a low serum folate results was 4.5ug/L range is 4.8-19.0 was prescribed folic acid

My thyroid results are

TSH 2.8 range 0.4-5.0

T4 11pmol/L range 9-19

Hopefully my post make sense

Thanks Anita

[bantam12]

My folate is 2.3 same range, can't take supplements so rely on high folate foods.

[anitajeanwebb]

Hi , how long have you been on folate? Thanks 😊

[SlowDragon Administrator in reply to anitajeanwebb]

You need to click reply for humanbean to see you asked question

Like many thyroid patients I take daily vitamin B complex continuously,plus daily vitamin D, and separate magnesium (have done for 5 years)

Retest folate, ferritin and B12 levels once year minimum

Vitamin D twice year

It’s trial and error what dose vitamin D each person needs to bring levels up

[porter5]

instead of folic acid, best form L-Methylfolate

[nellie237]

Hi,

Me too. Early this year I got online access to all my old results (excellent advice from here) and found that I have been constantly borderline or under range for years. Ferritin too.

I was recently prescribed 5mg Folic Acid for 2 months. NICE guidelines say 3 months, but my GP said that they are finding that 3 months takes people way over range. I think he was probably right. I went from 2.3 ug/L (Range 3.4 - 12.2) to 18 ug/L in the 2 months. I have since been supplementing with a B-Complex, and last result was 8ug/L.

It looks like you need an increase in thyroid meds too.

[anitajeanwebb in reply to nellie237]

My docs have prescribed for 3months have got to have a blood test soon to check as it’s nearly 3mths x aren’t my thyroid meds in range though? X

[nellie237 in reply to anitajeanwebb]

I'm guessing that you haven't been feeling great with those results, and that its probably not just the low folate that was making you feel rubbish.

TSH should be under 2 for patients treated with Levo. Your FT4 at 11 is only 20% through range, which is really very low. Most, if not all of us here would be feeling dreadful with those results. We are all different though.

Its a bit like the usual NHS range for Haemoglobin is about 110-150g/L, and if you had a result of 118 (20% through range) your GP may say that you are fine, but you are very, very likely to be anaemic. Sometimes they set the bar too low.

Bear in mind that the body only stores Folate for about 4 months.

[SlowDragon Administrator]

Low vitamins linked to being under medicated for thyroid

TSH is too high and Ft4 is too low

How much levothyroxine are you currently taking

Aim is to have Ft4 at least 50-60% through range and TSH always below 2 …..usually TSH around one

Always test thyroid levels as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Important to regularly retest vitamin D, ferritin and B12 too

[anitajeanwebb in reply to SlowDragon]

Hi there thank you for replying, I’m currently taking 125mg thyroxine on alternate days 100mg the other days , have been like that for a while, I’ve was told to lower the dose, my results are in range though aren’t they?

Thanks Anita

[SlowDragon Administrator in reply to anitajeanwebb]

You need dose increase, not reduced

Ft4 11 (9-19)

Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Ft4 is only 20% through range

Aiming for Ft4 at least 50-60% through range

[anitajeanwebb in reply to SlowDragon]

It was in the morning the test but probably only about 12 hrs after taking thyroid meds, I really struggle to understand all of this, I know i should after all this time, but my brain just doesn’t seem to retain any information, and this is a a lot to take in, I really appreciate you and everyone trying to help me, I’ve been to my doctors before and said that I don’t feel that well, and that I think my ranges are probably not right, but just get told I’m in range, and when I haven’t got a clue, they just can talk me out of any other way to help, if this makes sense,😕

[SlowDragon Administrator in reply to anitajeanwebb]

Request an increase of levothyroxine to 125mcg every day,

Ft4 is very low and if you had taken levothyroxine 24 hours before test Ft4 result would have been even lower

Do you always get same brand levothyroxine at each prescription

Get FULL thyroid and and vitamin testing 6-8 weeks later. Only do test early Monday or Tuesday morning and then post back via tracked postal service

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested, plus vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Or

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

Or

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

[SlowDragon Administrator in reply to anitajeanwebb]

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

(That’s Ft3 at 58% minimum through range)

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor



please email Dionne at

[e-mail]

[anitajeanwebb in reply to SlowDragon]

Hi I’ve been on the thyroid uk, but not sure where I should be looking to find the articles so I can print and show doctor.? I would be very grateful if. You could show/tell me where I should be looking please? Thank you 😊

[SlowDragon Administrator in reply to anitajeanwebb]

Email in my reply above

Also these links

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.

NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine

Note that it says test should be in morning BEFORE taking levothyroxine

Also to test vitamin D, folate, B12 and ferritin

sps.nhs.uk/wp-content/uploa...

[humanbean]

Personally I wouldn't take folic acid, I would take methylfolate which is easily found on supplement websites. The reasons why this is a good idea are given in this link :

chriskresser.com/folate-vs-...