Good morning,
I had a blood test 4/3/22. Just checked my results online. These were tested- Serum vitamin B12 level, Serum ferritin level , Serum folate level.
The result is borderline & doesnt need any further action.
Shall I contact the GP and follow it up?
Also tested for these-Calcium profileSerum C reactive protein level
Liver function tests
Results- Abnormal but expected, no further action
Please add actual results and ranges
Was test done early morning, ideally just before 9am, and last dose levothyroxine 24 hours before test
Looking at previous posts
You have Hashimoto’s. Like many Hashimoto’s patients you started with transient hyperthyroid results and symptoms before becoming increasingly hypothyroid
Now on 100mcg Levothyroxine (accord brand)
ESSENTIAL to test vitamin D, folate, ferritin and B12
Add any results just done
Have you had coeliac blood test done yet
If not, request testing BEFORE considering trial on strictly gluten free diet
Thank you SlowDragon
Ferritin is deficient
See GP
You are likely to need iron supplements, possibly an iron infusion
Definitely a coeliac blood test too
Are you vegetarian or vegan
Do you have heavy periods (common when anaemic and/or hypothyroid)
Low iron and/or low ferritin frequently linked to hair loss
Heavy periods are classic sign of being hypothyroid and will lead to low iron and ferritin
cks.nice.org.uk/topics/anae...
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Also See page 7 on here
rcn.org.uk/-/media/royal-co...
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat every day , pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
List of iron rich foods
Links about iron and ferritin
An article that explains why Low ferritin and low thyroid levels are often linked
preventmiscarriage.com/iron...
irondisorders.org/too-littl...
davidg170.sg-host.com/wp-co...
Great in-depth article on low ferritin
oatext.com/iron-deficiency-...
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
healthunlocked.com/thyroidu...
restartmed.com/hypothyroidi...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Medichecks iron panel test
medichecks.com/products/iro...
Iron and thyroid link
healthunlocked.com/thyroidu...
Posts discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Chicken livers if iron is good, but ferritin low
healthunlocked.com/thyroidu...
Heme iron v non heme
hsph.harvard.edu/nutritions...
Good explanations of iron
theironclinic.com/iron-defi...
theironclinic.com/ironc/wp/...
Excellent reply by Blearyeyed about iron in this post
Request/insist on vitamin D test too
Highly likely to be deficient unless you are already supplementing vitamin D?
pubmed.ncbi.nlm.nih.gov/286...
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
pubmed.ncbi.nlm.nih.gov/273...
Vitamin D insufficiency was associated with AITD and HT, especially overt hypothyroidism. Low serum vitamin D levels were independently associated with high serum TSH levels.
pubmed.ncbi.nlm.nih.gov/300...
The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.
ncbi.nlm.nih.gov/pmc/articl...
Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency and serum calcium levels for all hypothyroid patients.
B12 is too low, but not low enough for GP to consider prescribing any supplements
Folate is mid range
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 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 recommended vitamin B complex that contains folate, but they 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...
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and continue separate B12
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.
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...
Extremely common with Hashimoto’s to develop gluten intolerance
Before considering gluten free diet get coeliac blood test done via GP
With such low ferritin levels…..GP should be testing….even says to do so on those results
nice.org.uk/guidance/ng20/c...
1.1 Recognition of coeliac disease
1.1.1 Offer serological testing for coeliac disease to:
people with any of the following:
persistent unexplained abdominal or gastrointestinal symptoms
faltering growth
prolonged fatigue
unexpected weight loss
severe or persistent mouth ulcers
unexplained iron, vitamin B12 or folate deficiency
type 1 diabetes, at diagnosis
autoimmune thyroid disease, at diagnosis
irritable bowel syndrome (in adults)
first‑degree relatives of people with coeliac disease.
How long have you been on 100mcg levothyroxine
Have you had thyroid levels retested since starting on levothyroxine?
Always test early morning, ideally before 9am and last dose levothyroxine 24 hours before test
SlowDragon i started take 100mcg of Levothyroxine 3/7/22
I haven’t had my levels checked yet, waiting for endro appointment
I had the test 8.50am and didn’t take Levo for 24 hrs
So too soon to retest thyroid yet
Test after at least 8 weeks starting on 100mcg …and having started on a decent dose ….more like 3 -6 months time
GP should be looking at low ferritin levels though
And get vitamin D test and coeliac blood test
SlowDragon thank you for all the info
SlowDragon thank you. I will ask them to regularly complete these tests
You are a little bit unusual in that you have only one test out of range. Most people will find more than one when this number of tests (26?) are done. The chances of getting all the tests in range are about 26 in 100, less because some like ferritin are have healthy limits rather than a 95% reference interval.
However, your ferritin is low, it should be checked. Most women will have a ferritin below 30 but 15 is a bit too low. See originalText and originalText for typical ferritin levels. A ferritin of 40 ug/L is pretty good going for pre-menstrual women, fewer than half have a ferritin above this level.
The WHO state that one third of women of reproductive age are anaemic. Note these women do not exhibit the horror stories of hair loss etc. that are often put on commercial medicine websites. The WHO has a cut-off of 15 ug/L for iron deficiency originalText . So, you would be classified as iron deficient and should see your doctor for this. It may just be a matter of supplementing or change of diet but it makes sense to check it out.
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