Should I get an MMA test?

[NWA6]

Backstory - Hashi for 12yrs, 2 + years with added T3. History of blood tests for thyroid and Vits/minerals.

I’m not great at taking my Vits/minerals regularly. So I haven’t had any supplements for at least 2mths because I had Covid, family issues and then another serous infection. So here we are with today’s results. T4. Looks excellent (given that I’m on combo treatment) however T3 has dropped and I’ll be adding some more in. The lower folate and B12, made me look at some blood tests from May 2021. With those my MCV was just out of range 106.8 (75-105). It’s always been around 100, this is the first time it’s gone over. And my Haematocrit was 0.47 (0.37-0.47)

Do you think it’s worth looking for anaemia?

Edited to add - 2 severe bouts of vertigo this year, both lasting more than 1wk

[SlowDragon Administrator]

More likely you just need to supplement continuously Vitamin D and vitamin B complex …

Plus a separate B12, initially, though probably not B12 continuously unless vegetarian

What’s your ferritin result

[NWA6 in reply to SlowDragon]

Ferritin 74.5 (13-150)

The thing is with B12, (and I’m a meat eater), is that as soon as I stop B12, it goes low, so I may have to continually supplement.

But is there any point in getting diagnosed? Will it just be another thing to battle over with my GP?

[SlowDragon Administrator in reply to NWA6]

If B12 goes up when supplementing, then you are unlikely to have PA

With PA it’s difficult/impossible to improve low B12 on supplements and need B12 injections

Are you absolutely strictly gluten free?

[NWA6 in reply to SlowDragon]

Just looked, my B12 has risen to 122, when supplementing. Folate has more than halved and ferritin remains steady. Yes gluten free.

[NWA6 in reply to NWA6]

Just checked my TSH and is trying to splutter back to life 😂. Usually it’s 0.002, so 0.01 is a vast improvement 😂

[SlowDragon Administrator in reply to NWA6]

What B supplements do you normally take?

Stopping any vitamin B complex a week before test as contains biotin

As B vitamins are water soluble, they drop quickly

Personally I supplement a separate folate and B12 during that week before test when have stopped B complex

I use Jarrow folate and Jarrow B12

[NWA6 in reply to SlowDragon]

I’ve done a bit of research and it all points to not taking oral B12. As my diet should give me more than enough, I may not be utilising it and so by taking oral B12, it looks like I have enough but actually that may not be true. So advise if to leave off for 4mths. See my true level and go from there with an MMA and/or IFA test. Even if they come back negative, those with PA or b12 deficiency would only recommend injections.

[Hidden]

High MCV points to hypothyroidism, which correlates with ft3 lower than before when MCV was normal, while low MCV hyperthyroidism, read some papers on it recently. How is your RBC? You really need to check hemoglobin with hematocrit and RBC to know more, including amount of platelets.

[NWA6 in reply to Hidden]

Everything else is always in range.

[Hidden in reply to NWA6]

Then it seems like a dip in ft3 causing this.