With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate 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)
currently cheapest on eBay
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
B12 range in U.K. is too wide
Interesting that in this research B12 below 400 is considered inadequate
To me it looks like vitamins are all problematic, but thyroid hormones are alright. Is that correct?
What thyroid meds do you take?
When did you take your last dose before test - should be 24 hours for Levo and 8-12 hours for NDT or T3 (splitting dose day before into 2 or 3).
How do you feel with those thyroid results?
The aim of a treated hypo patient on Levo only, generally, would have TSH 1 or below with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well.
So your TSH is on the high side and both FT4 and FT3 are below half way through range. Those results, for most people on Levo only, would suggest undermedication.
Folate - Serum 6.2 ng/L (3.3 - 99999)
I don't recognise that unit of measurement for Folate, we usually see mcg/L or nmol/L but it is obviously low. Eating folate rich foods can help, as can a good quality B Complex containing methylfolate, eg Thorne Basic B. However, do not start taking this if you have symptoms of B12 deficiency, see below.
Serum Vitamin B12 242 ng/L (190 - 910) ng/L is the same as pg/ml below
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Some people with a B12 level in the 300s have been found to have B12 deficiency.
Do you have any signs of B12 deficiency – check here:
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results and if you have B12 deficiency is not detected and treated then this could affect your nervous system. B12 deficiency should be treated before starting folic acid because folic acid can sometimes improve your symptoms so much that is masks B12 deficiency.
If you don't come back and tell us and I have some suggestions for supplementing.
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Your GP should do an iron panel to see if you have iron deficiency plus a full blood count to see if you have anaemia. You can have iron deficiency with or without anaemia. You can have low ferritin without iron deficiency.
Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.
I was confused by the folate range too. Not that I have experience with them. But the max range seems extremely high. Is this because you can't have too much folate?
B12
Yes, I have symptoms of B12 defiency (brain fog, lower cognitive ability, can't find words/remember names, restless leg, fatigue, irritability, lethargy, loss of libido, persistent cough, constipation, knee pain (not sure if that's joint inflammation)
Also my brother has been told he has a B12 uptake issue. I recognise many symptoms on the list of what my mother has, but doctors have diagnosed her with rare connective tissue disorder.
Is the pernacious anaemia test to find out more detail about this?
Meds
I'm not on any meds. I don't take Levo.
When the endo diagnosed Hashimoto's (2019), they said he'd test TSH levels annually to check if my thyroid was destroyed to the point of needing treatment. The only thing to worry about was if I became pregnant. I asked about B12 (I already knew my brother's problems), he said he wouldn't test. Any symptoms I had were probably down to a virus. As they had gone a bit milder at that point, and that wasn't possible according to him with thyroid failure. Hashimoto's was progressive and not fluctuating.
I was confused by the folate range too. Not that I have experience with them. But the max range seems extremely high. Is this because you can't have too much folate?
Folate comes with different ranges, just to confuse things. Some come with a proper upper and lower limit, eg 3.89-19.45, some just say >3.89, then you get this stupid one. If it starts with 3.89 I think it's safe to assume that the upper limit would be 19.45 and folate is recommended to be at least half way through range so we would say get into double figures.
Is the pernacious anaemia test to find out more detail about this?
The PA test will determine if PA is the cause of B12 deficiency. It is just one cause of B12 deficiency. PA is an autoimmune disease that affects the stomach and prevents you from absorbing B12 from food. If you have Hashi's (autoimmune) it's possible that you may develop other autoimmune conditions.
My GP wants to wait to see how I feel after supplementing vitamin D and iron first. But taking in forum's comments, I don't feel comfortable ignoring B12. The b12d.org checklist leads me to the right box of 'severe B12 deficiency'.
Does the Active vit B12 test on Medicheck for example give me all the information I need?
Does the Active vit B12 test on Medicheck for example give me all the information I need?
No. The test you've already had done is Total B12 which measures the total amount of B12 - both bound and unbound. It's the unbound B12 that is active and available for the cells to use. The Active B12 test measures just the unbound active B12 that's available to the cells but it doesn't tell you if the B12 is actually getting into the cells. Like the Total B12 test, if the result of the Active B12 test is low it suggests possible B12 deficiency hence suggesting further testing to confirm this.
Can I test for Pernicious Aneamia myself?
Yes but it's expensive and requires venous blood draw, and if it shows PA you'll need B12 injections so will your GP accept the results?
Medichecks PA test £280 (less 10% with code from TUK):
Thank you for all this SlowDragon and Seaside Susie!
I felt a little bit overwhelmed this morning reading it all. I thought I had my tests done now and could start looking for solutions. But I'm finding out that's not where I am yet.
I didn't enjoy my last doctor's appointment (being told it's in my head, having to persuade professionals to take tests etc), so going back to ask for more tests is not something I'm looking forward to! There's a 6-8 wks waiting time for an appointment. Longer if I want to choose the GP. And I can't start taking any supplements till then. And you're right after that wait they might full well refuse to do the tests anyway, because to the doctor it all looks within range. So it feels deflating at the minute.
But..I've cleared my mind a bit. I might not be there yet, but I have been moving forward. So will just continue with the next step..and then the next step..
So I need:
Full Iron panel
Pernicious aneamia
Coelic test
Vitamin D test
Can you explain to me, please, why I need full iron and pernicious anaemia? Is Vit B12 and Ferritin not sufficient?
Can you explain to me, please, why I need full iron and pernicious anaemia? Is Vit B12 and Ferritin not sufficient?
The full iron panel will test serum iron, saturation percentage, total iron binding capacity and ferritin. Testing ferritin alone cannot diagnose iron deficiency. The full iron panel, particularly the serum iron and saturation, will show iron deficiency.
Your full blood count doesn't show anaemia so you could have iron deficiency without anaemia, but you could just have low ferritin so you need the iron panel to determine if you have iron deficiency.
I have explained above about what pernicious anaemia is. It is just one cause of B12 deficiency. If you have PA and can't absorb B12 from food then you must get it another way, with PA it's generally B12 injections for life. Other causes of B12 deficiency might be successfully treated with oral supplements.
I'm booked in at doctors on Monday. Vitamin D and full iron is definitely on the list to ask for. I'm prepared with notes and all the info you and SeasideSusie have provided me with. 🤞
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)
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)
Thorne currently difficult to find at reasonable price, should be around £20
If you want to try a different brand in the meantime, one with virtually identical doses of the ingredients, and bioavailable too, then take a look at Vitablossom Liposomal B Complex. Amazon sometimes has it branded Vitablossom but it's also available there branded as Yipmai, it's the same supplement
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
Retest full thyroid and vitamin levels 3-4 months after improving all four vitamins
Always test thyroid early morning around 9am latest
No I haven't started B12 supplements yet. The doctor denied my request for pernicious aneamia test by saying "see how you feel after Vit D supplements. Also supplement with iron if you want. If symptoms persist, we'll see." So I have been holding off until I got this both sorted.
I think you said to not supplement Vit B12 until you have done PA test?
I have been feeling quite a lot better to be honest. But it's so long ago I felt 'normal' that I I'm not sure if this is that. But because my brother has B12 issues, testing would relief my worries.
Is PA something that you test for once and then will always know if that's what you have? (Similar to thyroid antibodies?) Or can you develop it at some point? And potentially need re-testing in the future?
Ah I see. I saw it was expensive £280 at Medichecks. (medichecks.com/products/com... Hence I was going to bug my doctor for it again.
But is there any point in testing for it privately when it's often an unreliable test?
If testing is not being done, I'm assuming diagnosis is often made by supplementing and re-testing if that raises B12 levels instead, is that right?
SeasideSusie when you have a bit more energy, could I hear your thoughts too please. I think you advised me last time to not start supplementing until I had a test done.
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