Blood test results, B12 & Uric acid/gout

[C2k42]

Hi, I have had blood tests that show I am probably deficient in B12, I’m going to make an appointment with a GP to see about getting a methylmalonic acid test to confirm but do the rest of my results look ok? I haven’t been diagnosed with any thyroid problems and I’m not taking any thyroid meds, just supplement with Magnesium, D3, K2 and C.

Ferritin = 352 ug/L (Range: 30 - 400)

Folate serum = 5.98 ug/L (Range: >3.89)

Vitamin B12 active = 64.8 pmol/L (Range: >37.5) (87.828 pg/mL (Range: >50.8264))

Vitamin D = 195 nmol/L (Range: 50 - 175)

TSH = 2.19 mIU/L (Range: 0.27 - 4.2)

Free T3 = 5.41 pmol/L (Range: 3.1 - 6.8)

Free thyroxine = 16.5 pmol/L (Range: 12 - 22)

Thyroglobulin Antibodies = <10 kIU/L (Range: <115)

Thyroid Peroxidase Antibodies = 9.19 kIU/L (Range: <34)

I also have high uric acid levels (over 405 umol/L (300 - 350 = good)) and get gout flare ups that I take indomethacin for, I am considering asking to start on Allopurinol but I know that is medication for life. I have read that starting B12 injections can cause flare ups with gout so am a bit concerned about getting any.

I’m wondering is there a link somewhere between the low b12 and high uric acid levels, could it be that I am low in something meaning I’m not digesting meat properly to make b12 available and at the same time breakdown the purines food leading to high uric acid and gout?

Thanks for any advice or suggestions.

[SlowDragon Administrator]

Please add ranges on these results or say which company did tests

Presumably these are private tests as it’s Active B12

Active B12 over 70 is fine …..not low

[C2k42 in reply to SlowDragon]

I've added the range's now.

I thought b12 needed to be over 550pg/ml? perniciousanemia.org/b12/le...

[SeasideSusie Remembering in reply to C2k42]

C2k42

I thought b12 needed to be over 550pg/ml?

That is for the Total B12 test which measures both inactive and active B12 but doesn't give individual measures just a total. Active B12 only measures active B12 and is said to be the better test.

Vitamin B12 active = 64.8 pmol/L (Range: >37.5) (87.828 pg/mL (Range: >50.8264))

I haven't seen it given in two unis of measurement/ranges like that before so I'll jut comment on the one normally seen.

64.8 (37.5-188)

The range I've included here is the one usually used by Medichecks but they seem to have gone over to sometimes using >37.5 which isn't very helpful.

We generally say here that an Active B12 level below 70 suggests testing for B12 deficiency, but check to see if you have any signs/symptoms before asking for test. If you have any then list them for your GP which may help in his decision to test:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

If you don't have any you may find that supplementing with a B12 sublingual plus a good quality B Complex to keep all B vitamins balanced is enough. Once Active B12 has reached 100 it's probably enough to drop the B12 sublingual and just continue with the B Complex.

When taking a B Complex this should be left off for 3-7 days before any blood test as it contains biotin and when biotin is used in the testing procedure (most labs use it) then it gives false results.

[SlowDragon Administrator]

Looking at previous post from 2 years ago

healthunlocked.com/thyroidu...

Obviously you have been working on improving low vitamin levels

Did you get tested for pernicious anaemia

[C2k42 in reply to SlowDragon]

I haven't been tested for pernicious anaemia yet, was giving vitamins time to see if they helped!

[SlowDragon Administrator in reply to C2k42]

Have you been taking any B12 or vitamin B complex?

Low folate

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-...

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...

Low B12 symptoms

b12deficiency.info/signs-an...

If 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...

[C2k42 in reply to SlowDragon]

Thank you for your comments, makes sense, I haven't been taking any B12 or B complex supplements. I have ordered the Thorne Basic B so will give them a go for a few months and check bloods to see if that's helped bring my B12 up as someone has mentioned that my folate is on the lower side.

Looking at the signs for B12 deficiency there's quite a few that I can relate to so it would be nice to see my B12 closer to 100 than being just under 70 and see if any of my signs are helped.

Thank you.

[shaws in reply to C2k42]

If your B12 is low, ask GP to test for pernicious anaemia before you supplement with B12.

If we do have pernicious anaemia we have to have regular B12 injections as our stomach can no longer absorb B12.

[humanbean]

Folate serum = 5.98 ug/L (Range: >3.89)

We usually suggest that folate should be in double figures. Please read this link :

chriskresser.com/folate-vs-...

It tells you which are the best types of folate supplement, and why.

Vitamin D = 195 nmol/L (Range: 50 - 175)

If you are supplementing vitamin D I would suggest you give it a break for 3 - 4 months then re-test. Optimal is usually somewhere between 100 and 150 nmol/L. You might want to stick to a maintenance dose rather than a dose which raises your level. For many people that is around 2000 iU per day, but some need it to be higher to keep it where they want it.

Vitamin B12 active = 64.8 pmol/L (Range: >37.5)

Your active B12 is not deficient but it isn't optimal either. The minimum suggested on this forum is 70+, but optimal for people with thyroid disease is considered to be 100+.

biolab.co.uk/docs/vitaminB1...

Please note that for the body to make full use of your B12 you need good levels of folate. A good supplement for B12 is methylcobalamin. If you start supplementing B vitamins it is a good idea to take a B Complex with activated B Vitamins (i.e. it contains methylcobalamin plus one of the folates mentioned in the Chris Kresser link I gave above, as well as the other B vitamins - Thorne Research Basic B is a good one). This may be sufficient to raise your folate and B12 to optimal without separate supplements. It is not a good idea to allow one or two B vitamins to rise without considering all the other B vitamins too, which is why a B Complex is suggested.

Thyroglobulin Antibodies = <10 kIU/L (Range: <115)

Thyroid Peroxidase Antibodies = 9.19 kIU/L (Range: <34)

Your levels of antibodies are within range, suggesting that there is no evidence of Hashimoto's Thyroiditis (autoimmune thyroid disease). Antibody levels do fluctuate, so there is no guarantee that your levels will stay good forever.

TSH = 2.19 mIU/L (Range: 0.27 - 4.2)

Free T3 = 5.41 pmol/L (Range: 3.1 - 6.8) --- 62% of the way through the range

Free thyroxine = 16.5 pmol/L (Range: 12 - 22) --- 45% of the way through the range

You might find this link of interest - it shows you the distribution of TSH in healthy people with no known thyroid disease :

healthunlocked.com/thyroidu...

Your TSH is still within the bounds of what would be "normal" for most healthy people. Once it gets to 3 or above your thyroid is starting to show definite signs of distress and in some countries you would be treated for hypothyroidism with a TSH of 3+. If you live in the UK treatment is far more sadistic, and patients have to have a TSH of greater than 10, or in some cases greater than 5 if TPO antibodies are high.

Your hormone levels (the Free T4 and the Free T3) are currently at a level which would be sufficient for most healthy people.

[C2k42 in reply to humanbean]

Thank you for your comments, good to know that my Thyroid seems to be within normal ranges and not showing signs of any diseases. I have ordered some Thorne Basic B complex to take for a few months to see if it helps increase my folate level.

Thank you.

[jaz03]

Hi. I was diagnosed B12 deficient in 2010.

I hunted around. I take Gold Top SOLGAR under tongue.

I take on two days week 1 x dissolve under tongue.

This product was tested with my doctor.

In the first instance I went from 150 - 900 B12 taking pill under tongue every day for 6 weeks.

I am 73yrs. No gal bladder.

My result last week was 465.

cheri

[Clydeiknowyou69]

Hi, I've to get bloods tested for uric acid next week. I have calcium deposits in my (R) knee joint. Did you have this, is this the cause of your high uric acid levels do you know?