Hi lovely people, after your advice i went along with my daughter to GP with the private thyroid blood results as her Free T4 was below range. GP did know what to make of this so arranged for them to be tested again along with others. Hope you can see this 😑 am not good tec . So
TSH 3.3 (0.27- 4.20
FreeT4 12.7 ( 12-22)
So just in range. Could only get a blood appointment for 9.40 am and luck to get that as she was going back to uni few days after. So will keep an eye on thyroid and test in a few months i suppose as GP not concerned. Big concern though is that her folate is 2.6 ( 3.90- 26.80). Gp said it is on the low side so eat more cereal 😣 LOW side!!! So I've got her Thorne B complex. Do you think this is enough to improve this and her B12 . Any advice greatly appreciated. Thanks x
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De8813
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That is a truly appalling result even though it is in range by a tiny smidgen. She needs to be tested for Pernicious Anaemia (PA). She shouldn't take B12 or folate until she has been tested.
Please join the PA forum on HealthUnlocked and ask for advice :
Even if it turns out your daughter doesn't have PA (and the testing isn't very reliable - there are lots of false negatives) she needs to be treated for B12 deficiency even without PA and this would involved regular injections for a while.
Thank you for this. Gp spoke to my daughter over the and didn't even mention B12 ,suppose cos to him inrange is fine. My daughter has returned to university now so no chance of getting anything sorted. Will read all this information and join PA as you advise. My daughter has already started the B complex and says she can feel the difference already, thank you x
When someone has low B12 and/or low folate it will have an impact on the size of red blood cells. The same is true of low iron / ferritin.
The average size of red blood cells is shown by the result of the MCV - Mean Cell Volume.
When MCV is low in range or under the range it suggests that iron and/or ferritin are low.
When MCV is high in range or over the range it suggests that B12 and/or folate are low.
When iron/ferritin AND B12/folate are low the results of MCV are unpredictable.
Given that your daughter's B12 and folate are very low in range (B12) and under the range (folate), and yet her MCV is still in the lower half of the range it makes me think that her iron and/or her ferritin might not be great either. Preferably an iron panel would be carried out, rather than just a ferritin test.
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I've just noticed that your daughter's ferritin has been tested and is 50 (13 - 150). That is probably adequate for someone who isn't hypothyroid, but since her TSH is over 3 and her Free T4 is scraping the bottom of the range I think she is hypothyroid and needs her ferritin to be higher - I suggest 90 - 110, although mid-range may be sufficient. In some countries she would get a diagnosis of hypothyroidism once TSH reaches 3, but in the UK she has to wait until TSH is 10+. Extremely sadistic, I know. This suggests to me that she could probably do with more iron and ferritin - but you'd preferably have to get iron tested before supplementing iron, for the reasons given in this link :
One piece of good news is that despite the low levels I've already mentioned your daughter is not anaemic. Doctors use haemoglobin level to decide this, and your daughter's is well in range.
As she’s started vitamin B complex no point testing for pernicious anaemia
Recommend she also starts a daily separate B12 as well
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
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.
Come back with new post once you get vitamin D result
Watch out for good money off offer on FULL thyroid and and vitamin testing kit - order one in ready to do when she’s home from university in 6-8 weeks time
List of private testing options and money off codes
Thank you SlowDragon. Just about managed to get B12 tested . Told us not to go to " certain" hospital for bloods as they refuse to test B12 and will on test TSH . Will study all this advice xx
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