Blood results - low b12: Hi, Please can I have... - Thyroid UK

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Blood results - low b12

bollin profile image
13 Replies

Hi,

Please can I have some advice on my blood results...

I have Hashimoto’s (Dx 13yrs ago), am hypothyroid (Dx 2yrs ago), take 100mcg levothyroxine, 4yrs ago positive parietal cell antibodies, negative IF antibodies and very low B12. Was given a single B12 shot and told not pernicious anaemia without positive IF antibodies.

Currently not taking any supplements but need to start again (stopped 2yrs ago when started levothyroxine mainly because I wanted to leave a 4hr gap so nothing interfered - but then I'd forget 😳) B12 is low again, I think with Hashimoto’s it’s best to be 700-900? Obviously GP said all results are normal. Is it worth retesting IF antibodies? Or asking for a B12 shot? Or would sublingual work ok? I'm not sure if I simply don't absorb B12 due to parietal cell antibodies or could it possibly be pernicious anaemia?

Medichecks from Jan - TSH 0.55, ft3 4.8, ft4 18. My vitamin D was 82 in July.

Above are recent GP blood results.

Thank you :)

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bollin
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13 Replies
SlowDragon profile image
SlowDragonAdministrator

Many (most?) thyroid patients need to supplement vitamin D and B complex continuously to maintain good vitamin levels

Some patients also need to add separate B12 as well

Your B12 is now very low so will definitely need separate B12 initially

Are you vegetarian or vegan?

You can try daily supplements

Do you have Low B12 symptoms ?

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week 

B12 drops 

healthunlocked.com/thyroidu...

B12 sublingual lozenges 

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate 

healthunlocked.com/thyroidu...

Starting Vitamin B complex week or so after starting B12

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) 

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. 

If you want to try a different brand, 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

amazon.co.uk/Yipmai-Liposom...

or available as Vitablossom brand here

hempoutlet.co.uk/vitablosso... &description=true

Or 

Igennus Vitamin B complex. Nice small tablets. Full dose is 2 tablets per day. Most people are fine with just single tablet 

igennus.com/products/super-...

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

bollin profile image
bollin in reply toSlowDragon

Hi, thank you so much for the information. I’m not veggie or vegan, have always struggled with iron deficiency anaemia so my symptoms - headaches, lethargy, brain fog - I put down to that or being peri menopausal. I’ll definitely start supplementing again. I had a genetic tests a few years ago, can’t remember if I have MTFR or not, I will double check.I was wondering if anyone think the results indicate pernicious anaemia or not. I’ve read somewhere that if you have parietal cell antibodies it’s pernicious anaemia regardless of IF antibodies and somewhere else says you must have IF antibodies for a diagnosis?Thanks 

Jaydee1507 profile image
Jaydee1507Administrator in reply tobollin

There's a PA group here on HU. Suggest asking there.

bollin profile image
bollin in reply toJaydee1507

yes will do thank you :)

shaws profile image
shawsAdministrator in reply tobollin

You must ask your GP to check for Pernicious Anaemia. If we do have P.A. we have to have regular B12 injections.

The usual is to have P.A. injection every 3 months but I have mine monthly.

bollin profile image
bollin in reply toshaws

thank you. I just realised my result is 280ng/l and not pmol/l which I think the minimum level of 500 is in. Do you know the optimal levels are with the unit so I can work out where I am up to. Thanks

shaws profile image
shawsAdministrator in reply tobollin

I'm sorry I don't know the optimum levels and hope that another member will be able to respond to your query.

SlowDragon profile image
SlowDragonAdministrator

retest vitamin D

Likely lower in winter if not been supplementing

Ferritin would be better nearer 100. Look at increasing iron rich foods in your diet

As you have Hashimoto’s are you on gluten free and/or dairy free diet

bollin profile image
bollin in reply toSlowDragon

Yes I need to retest vitamin D - I’ve been dairy free since birth - milk protein allergy. I’ve been GF for about 6 or 7 yrs.

Thanks

SlowDragon profile image
SlowDragonAdministrator in reply tobollin

So with gluten and dairy intolerance you presumably have Hashimoto’s

Likely poor conversion of Ft4 to Ft3

Low Ft3 results in low vitamin levels

essential to test TSH, Ft4 and Ft3 together

Test early morning, ideally just before 9am and last dose levothyroxine 24 hours before test

cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

bollin profile image
bollin in reply toSlowDragon

Thank you, yes I was diagnosed with hashimotos 13yrs ago, I had my thyroid panel done in January for the endocrinologist (before the GP test I posted above).

Was taken in the morning with previous Levo 24hrs before. Would you say I’m converting ok? I know it’s within range but that doesn’t always mean anything :) Thanks

.
SlowDragon profile image
SlowDragonAdministrator in reply tobollin

FT4: 18 pmol/l (Range 12 - 22) 60.00%

FT3: 4.8 pmol/l (Range 3.1 - 6.8) 45.95%

You are likely to see conversion improvement with good B12 and ferritin

Possibly room for dose increase in levothyroxine too

bollin profile image
bollin in reply toSlowDragon

Thank you I’ll definitely work on improving my B12 levels

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