QUESTION ON B12

[mintgreenish]

B12 RESULTS 397 RANGE 200- 1100 PG/ML FOLATE RESULT > 24.0 RANGE> 5.4. DO I NEED TO SUPPLEMENT?

[SlowDragon Administrator]

Probably yes

At least a daily vitamin B complex, perhaps separate B12 as well

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (You can tip powder out if can’t swallow capsule)

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Do you have Low B12 symptoms

b12deficiency.info/signs-an...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 sublingual lozenges

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

healthunlocked.com/thyroidu...

What are your most recent vitamin D and ferritin results

[mintgreenish in reply to SlowDragon]

THANKYOU SLOW DRAGON. VIT D 55NG/ML . RANGE 30-100 NG/ML. NO FERRITIN TEST BUT VERY GOOD RBC AND HEMOGLOBIN , CLOSE TO TOP OF RANGE. HOW MUCH B12 DAILY AND B COMPLEX DAILY, WOULD YOU SUGGEST

[userotc in reply to SlowDragon]

Would you recommend doing an active B12 to confirm low levels first (and/or establish a baseline)? Mum's total levels have fluctuated in recent yrs, latest ~310. Dad's active is 61pmol/l so adjusting diet only (more difficult with mum as CKD).

[SlowDragon Administrator in reply to userotc]

Does she have low B12 symptoms

Would GP test for pernicious anaemia?

If GP won’t test just start supplementing

Poor kidney function can be affected by low thyroid levels

What’s her most recent TSH, Ft4 and Ft3

[userotc in reply to SlowDragon]

Symptoms always difficult to spot but possibly less-publicised ones only. None of those identified by our NHS nhs.uk/conditions/vitamin-b... but some on/off leg scratching and she thinks her memory could be better (dad also for both).

GP unlikely to do tests since she is 25% through their "normal" range!

Theyve tested thyroid but only TSH despite her repeatedly asking for fT3, fT4. Her TSH has been tested 5 times in past 4 years and been between 0.7 and 1.7 (latest 1.1).

So youd supplement before/without an active B12 to confirm low levels first (and/or establish a baseline)?

[SlowDragon Administrator in reply to userotc]

Well NHS doesn’t ever offer Active B12 test unless testing at St Thomas’s in London

Bottom of Range on Serum B12 much higher in other countries….in Japan bottom of range is 500

So does your mum take levothyroxine?

Suggest you get her Medichecks test, thyroid and vitamins- includes Active B12

[SlowDragon Administrator in reply to userotc]

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

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

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.

In U.K. medics never call it Hashimoto’s, just autoimmune thyroid disease (and they usually ignore the autoimmune aspect)

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

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...

[userotc in reply to SlowDragon]

Thanks. In response to your main points:

(i) No mum not on levo, never been diagnosed hypo (due to TSH only as I say!)

NB TSH generally tested early & fasted e.g. 0830h latest.

(ii) Planning Medichecks Adv Thyroid early 2022 for active B12 etc (NB Ive had it).

(iii) Vit D, folate, ferritin tested regularly & OK:117 (50-250), 13.7 (3-19), 71 (10-290)

[SlowDragon Administrator in reply to userotc]

So don’t start any B12 or vitamin B complex before doing test early 2022

[shaws Administrator]

This is a link that is informative:- It is very important that you are checked if there's a possibility that you have low B12 *which could be due to pernicious anaemia)..

patient.info/allergies-bloo...

[Juliehypo in reply to shaws]

I tested low for.B12. My legs were numb My dr told me to get on B12. So I started 1200 mcg sublingual B12 and I felt better in a week I’m wondering if B12 shots would be better. He didn’t elaborate. They never do. Thanks

[shaws Administrator in reply to Juliehypo]

Your doctor is ridiculous - if B12 is low and we've never been diagnosed as having pernicious anaemia, it is very important to be diagnosed.

When we have pernicious anaemia it is due to our stomach changing in that it cannot absorb B12 from food so frequent injections are necessary.

My mother's doctor told her she no longer needed B12 injections - The Result - she died of stomach cancer.

[Juliehypo in reply to shaws]

So sorry for you. I feel it completely necessary for all of us to get 2nd and 3rd opinions

[shaws Administrator in reply to Juliehypo]

My mother had been diagnosed about 15 years before, so GP shouldn't have withdrawn or told her that she needed no more B12 injections because they should be ''lifelong' injections.

Some GPs may not have the knowledge of how important Vit B12 is and what its function is in the human body.

I think your doctor is wrong in not giving you injections of B12 . The fact is that if we have Pernicious Anaemia our stomach cannot absorb B12, and that's why we are given injections.

[Juliehypo in reply to shaws]

I’d like to look into B12 injections. I will talk to my pharmacist. She seems to be very knowledgeable

[shaws Administrator in reply to Juliehypo]

Before injecting, ensure you have been diagnosed with Pernicious Anaemia. Normally we don't need B12 injections but if our stomach lacks the 'intrinsic factor' we will have pernicous anaemia.

.

[Juliehypo in reply to shaws]

Thank you