B12, folate

[Violet333]

In January, I managed to get B12 included in the blood tests (only by getting the nurse to write it down on the form at the time of the test). Level came back at 404 (range 197 to 771). I didn't know at the time to ask for ferritin and folate to be tested. GP put me on cyanocobalamin tablets, 50mcg x2 daily. A couple of weeks ago spoke with the GP about getting ferritin, folate and vitamin D included in the next tests, plus TSH, T3 and T4 which she agreed with. The tests were this week but only B12, TSH and T4 were included which is very annoying, plus they rescheduled the test for the afternoon. TSH has gone down from 3.23 to 2.26 but presume this drop to be due to a lower level in the afternoon. T4 was 15.5 last time, now 14.1 (range 12-22). My B12 level has now gone up to 487. Is this a reasonable increase after two months of cyanocobalamin? With no base line of folate I can't see her prescribing it, although there may be indications elsewhere that folate might be a problem - MCV has gone up but within range, and MCH is now out of range at 32.7 (range 27-32).

[SlowDragon Administrator]

Recommend getting FULL thyroid and vitamin testing

How much levothyroxine are you currently taking

Or are you still trying to get diagnosed and not yet on levothyroxine

ALWAYS test early morning and last dose levothyroxine 24 hours before test

Aim of levothyroxine is to increase the dose slowly upwards until TSH is around 1 and Ft4 in top 1/3rd of range

Currently

FT4: 14.1 pmol/l (Range 12 - 22)

Ft4 only 21.00% through range

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

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

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3 and includes BOTH TPO and TG antibodies -£29 

randoxhealth.com/at-home/Th...

Only do private testing early Monday or Tuesday morning. 

[greygoose]

Your doctor prescribes cyanocobalamin because it's the cheapest, but it's not the best absorbed. Also, all the B vits work together, so need to be kept balanced. Just taking one in isolation won't help you much, no matter what your level in the blood - blood tests don't tell you everything!

I would suggest you get a B complex with methylcobalamin (best absorbed) and methylfolate. So, if you do have low folate, that will bring the level up.

[samaja]

The increase in bloods is to be expected when you supplement but it tells you nothing about the actual level in the cells and will skew all future results. Have you taken any B12 before either on its own or within B complex or in foods fortified with it or energy drinks?

[Violet333]

The GP prescribed B12 for the two months before the test. I've been taking a multivitamin for years with B12 and folic acid, plus I have B12 enriched Engevita most days. My diet isn't rich in meat or fish but I do eat eggs. My suspicion is that both my folate and B12 levels are low and this is contributing to a struggling thyroid and highish cholesterol and triglyceride levels. Spoke to the GP yesterday and missing folate off the tests was a mistake (I got a uric acid test instead!). I'm having the test done on Monday so next week will see if folate is an issue.

[humanbean]

GP put me on cyanocobalamin tablets, 50mcg x2 daily.

There are four different kinds of vitamin B12 taken by people under different circumstances.

They are described here :

perniciousanemia.org/b12/fo...

The level that people should be aiming for is described here :

perniciousanemia.org/b12/le...

I have a good level of B12 - in fact it is over the range. After I had taken methylcobalamin for a few weeks at a high dose for the first time some of my life long health problems disappeared, although I will point out that they seemed to get worse for a couple of weeks at the start before improving.

B12 is one of the few nutrients that are not poisonous even in very high doses :

stichtingb12tekort.nl/weten...

Personally, I take methylcobalamin at a dose of 1000 mcg per day, four days a week. 50mcg per day is a pathetic amount that wouldn't raise B12 in a sparrow (in my personal opinion).

.

If you ever decide you need to start taking folate the best form is methylfolate. Please see these links for more info :

takecareof.com/articles/ben...

chriskresser.com/folate-vs-...

[Violet333 in reply to humanbean]

Sorry, meant to say thanks very much for those very useful links.

[shaws Administrator]

I would request that you have a blood test for Pernicious Anaemia. I have this condition and need regular B12 injections. I used to get a n injection every few months but now get them monthly.

My mother also had this condition but her GP stopped her regular B12 injections stating that she didn't need any more injections. That decision by GP caused my mother to develop stomach cancer that caused her early demise

[Violet333 in reply to shaws]

Which blood tests would indicate this condition?

[shaws Administrator]

The following link I hope is informative for you:-

hoacny.com/patient-resource...