Hi everyone. I posted a while back and you were all so helpful. I've taken a lot of advice from this forum, and my blood test results from last week show that all your advice has really improved my thyroid function. I got on top of my supplements and increased my Levo to 200mcg a day. My test results from last week were:
TSH 0.45 mu/L [0.3-5.0] - down from 3.86 in July
T4 14.5 pmol/L [7.9-16.0] - up from 10.9 in July
T3 4.7 pmol/L [3.8-6.0] - up from 3.2 in July
However, my ferritin is really bad:
Serum ferritin 10 ng/mL [15.0-300.0] - it was 28ng/mL when I last had it tested in Sep 2020
I also had a pernicious anaemia screen done last week, and the note from the GP on this was:
"The pernicious anaemia screen was negative, therefore you do not have pernicious anaemia and should not need to have B12 injections. Your B12 was not done on this occasion but the last test was on 14th July and the level was 233 which is well in the normal range."
They also checked my folate last week:
Serum folate 9.6 ug/L [2.5-9999.0]
I know that there is a link between iron and B12 but I'm confused as to what it could be if I don't have pernicious anaemia?
I also recall the advice that B12 under 500 can cause symptoms, so am basically ignoring the GP's comment that my B12 is "well in the normal range".
Should I push on the B12 issue? There really is no reason for my ferritin to be so low - I eat a decent diet with a decent amount of iron-rich foods, and I've been taking the pill back-to-back all summer so I've only had about four periods this year so far (previously the GP put my anaemia down to menorrhagia but that resolved itself once my thyroid levels improved a bit last year).
I suppose my question is: do I go out and get B12 injections on my own, or just start the Thorne Basic-B complex plus some of those sub-lingual lozenges that you have recommended?
I have been taking ferrous fumerate over the last few months and the GP has suggested I carry on, which I will of course, but could there be some other reason that my ferritin level is so low?
Thank you so much in advance, and apologies for the essay!
Nicola xx
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I suppose my question is: do I go out and get B12 injections on my own, or just start the Thorne Basic-B complex plus some of those sub-lingual lozenges that you have recommended?
Start on separate B12 supplement…..then after 10-14 days add Thorne vitamin B complex
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.
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
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
I am in awe of your knowledge and the advice you give on this forum.
With your permission there is one detail which might be a mute point, namely, when blood serum b12 reaches 500 to stop b12 supplementation and use the multi B. This is great advice for many but for someone prone to b12 deficiency and rapid onset when supplementation ceases there is a case for continuing supplementation to ensure serum levels remain above 500 and clinical symptoms don't return,
There is a clinical review paper called The many faces of cobalamin deficiency which you can google which discuses the importance of maintaining supplementation.
Yes….true ….if next test after going to just vitamin B complex shows drop in B12….will need to add separate B12 back in ….perhaps 3-4 days week….trial and error how many days per week
Vegetarian or vegans invariably need to continue with separate B12 as well as vitamin B complex at least a few days a week
It’s important to retest B12 and folate few months after any changes in supplement levels
Thanks so much Grey Goose. Can you remind me of the remedies / treatments for low stomach acid?
With the MTHFR gene - if I got tested and I do have that - would it change anything in terms of the supplements I need to take? What would knowing I have it change for me?
I recently tested positive for the MTHFR gene defect (C677T heterozygous) which can result in a 30-40% loss of function. My doctor recommended supplementing with the methylcobalamin form of B12 as opposed to the synthetic Cobalamin. He also wrote me a lab order for a homocysteine test as the blood serum test is unreliable.
A high homocysteine level may be an early indicator of vitamin B12 deficiency.
I'm currently supplementing with Integrative Therapeutics B12-Active™ Cherry - 30 Chewable Tablets and Thorne B-Complex #12.
Thanks SeasideSusie. I do have some of the B12 symptoms, mostly in the mental health category but also things like glossitis and tinnitus . I'll try the PA forum - thanks so much for the suggestion.
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
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
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
Not strictly either yet...I keep falling off the wagon. I manage to be strictly DF and GF for about three weeks at a time, and when I am strictly GF and DF I really notice a difference for the better! But I keep getting these regular episodes of feeling very depressed - tired, sad, angry, insomnia, etc - and then I lose all my willpower and treat myself, for example, to enormous slices of sourdough and butter with a large glass of red wine
I know it's not great and I am trying to address this. It's really hard.
I'm currently taking the Teva 100mg tablets. I take 200mg a day.
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