I posted a few months ago..I'll give a quick recap..
After feeling exhausted all the time I requested a blood test in April as I've had low B12 and had to have injections in the past. The nurse decided to also check TSH and liver function etc at the same time. When I called up for my results, the receptionist said it's all come back fine, no action needed. Following that I found a lump on my thyroid and had a biopsy which eventually came back as a cyst. The endo checked my blood test results and said no thyroid problem but low folate. Whilst nervously waiting for my results I joined this forum and became convinced I have under active thyroid. I'm always cold, low mood, I can't lose weight despite the fact I've been training for a half marathan (I did the great north run last month and have the great south 10 miler this month) and have been doing Joe Wicks 90 day plan, which the last 2 times I've done it I've got in amazing shape, now I can't lose a pound.
On the advice of a couple of members on here I asked the surgery for a print out of my April blood test. It says low folate - 2.96 (range 3.00 - 20.00) clinical review recommended. Vit B12 was 210 (range 145.00 - 914.00) so not classed as low, but not great I would say. Worryingly it also has Serum ALT level 44 (should be under 35.00) although it says no action required but has a ! in front of it, as does serum folate. So I'm a bit confused by that.
When I googled I found that you can lower elevated ALT by taking folate. Which I have been for a few weeks now.
I did do a blue horizon test which I posted the results for a few weeks ago. I hadn't done it fasted or early in the morning as recommended (I'd forgotten). So the TSH was only 1.36 (0.27 - 4.20). Whereas the NHS test from April which I did fasted at 7.30am shows TSH as 2.07 (0.30 - 4.80). I may have taken my steroid inhalers before I went though, I can't remember.
The main point of this post was to thank all of the knowledgeable and helpful people on here. And to back up their point of getting blood results printed off because I'm shocked that the receptionist told me everything was fine when it wasn't!
Has anyone got any info on the serum ALT level and if I should be concerned? Or just carry on taking the folate and ask for another test in a few weeks?
I'll probably do another blue horizon test soon to try and do it without taking my inhalers first in case that is lowering my TSH. Do I need to stop taking the folate before I do this?
Sorry this is so long, I wanted to try and include all the important bits! Hope you are all as well as can be xx
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Do I need to stop taking the folate before I do this?
The supplements that need to be stopped before a blood test are as follows:
Biotin or any supplement containing biotin, eg B Complex, stop for 3-7 days before test.
Iron, if having any iron tests, stop for 7 days before the test.
You can continue with your folate supplement (assuming it's a standalone folate) but on the day of the test leave everything until after the blood draw.
Vit B12 was 210 (range 145.00 - 914.00) so not classed as low
I've had low B12 and had to have injections in the past.
What was the reason for the B12 injections in the past. I was under the impression that once on B12 injections they were for life and repeat testing wasn't necessary as it would be inaccurate.
With your B12 at 210, do you have any signs of B12 deficiency, check here:
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Symptoms should take precedence over numbers where B12 is concerned.
You should not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this can mask signs of B12 deficiency and skew results.
I am taking a folate only tablet every day. I will hold off until after the test, thank you.
When I had my B12 tested before, I was about 24 years old and I'd had a bad time with gastroenteritis, I couldn't recover from it, I had an upset tummy for a long time afterwards so I assumed that's why I just had one lot of injections, I think it was 6 or 8 I had. Following the tummy problems I was really fatigued, I was just working and sleeping during the week. I needed at least 9 hours sleep to be able to get through the day. Which is how I have been feeling, but I don't think it's as bad now as it was then, unless it's just because I have young children now so I have no choice but to get up and get on!
The doctor never said I'd need the injections for life. I can't remember if my levels were retested following the course of injections to be honest. It was 9/10 years ago.
I do have quite a few of those symptoms. That's really helpful, I will print it off.
Would that mean stopping the folate tablets for a week before the b12 test?
500? Wow! I can't see the gp agreeing with that, I can picture him laughing at me like he does. I wonder what it was 9/10 years ago when they gave me the injections. The 210 result was this April.
Looking at the symptoms on the B12 page, it does make me wonder if I'm barking up the wrong tree with hypothyroidism. I may have been right in the first place. Shame doctors can't take us seriously.
Would that mean stopping the folate tablets for a week before the b12 test?
Normally you wouldn't stop your folate just becausey you're having a thyroid test or the thyroid/vitamin panel, you'd just take that day's tablet after the test on the day. It's bioton that you'd need to stop because when biotin is used in the testing procedure (which most labs do) then it causes false results. Biotin is not found in a standalone folate supplement but can be found in other supplements such as B Complex so it would need checking.
However, as you have symptoms of B12 deficiency you need to stop the folate altogether and get your GP to test for B12 deficiency and pernicious anaemia. Taking folate will mask signs of B12 deficiency and may skew results.
Has anyone got any info on the serum ALT level and if I should be concerned?
A few years ago I had an ALT result of 42 with a reference range of 0 - 33. When I read up about it I found that it is an early sign of fatty liver disease which can be caused by excessive alcohol intake (and I don't drink) or a high sugar and carb intake, and I surely do love my sugar to an embarrassing degree.
Anyway, I put in some effort and reduced my intake of sugar and stodgy carbs (biscuits and cakes) and 8 months later I did some more testing and found my ALT had reduced to 18 with a reference range of 1 - 33.
I read a lot of posts on this forum, and it is very common in people who have a single high result on a liver function test for it to be the ALT which is slightly raised.
A link you might find of interest - click on the + signs for more info :
Thats really interesting, thanks for posting the link. I don't drink much either which is why I was a bit confused by it, but like you I do like carbs so maybe its that I've seen the nurse and shes agreed to re do my bloods from april to see if anything has changed.
She said that ALT is nothing to worry about unless its over 3 times the range. Which it seems to say online too, but I find it strange that they give you a range but then tell you to ignore it! 🤔
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Thank you for good advice and much support 
Happy dance time! Thanks to all your great advice
Thanks to all the advice on here
Amiodarone for a month: thyroid blood test results Looking for advice/comments Thank you!! 
Next lot of test results for your advice
