Recent blood tests , Vit B 12 and folic acid

[Syrupafigs]

I have hypothyroidism and presently take Thyroxine (accord) 50 micrograms alt days and 100micrograms alt days.

I presently do not take any supplements and would like advice about vit B12 and folic acid, I am having a serum methylmalonic acid (MMA) blood test next week to assess any Vit B 12 deficency

below is a copy of my latest blood tests

Inflammation

CRP HS 0.961 mg/L (Range: < 3)

Iron Status

Ferritin 165.00 ug/L (Range: 30 - 650)

Vitamins

Folate - Serum X 8.1 nmol/L (Range: 8.83 - 60.8)

Vitamin B12 - Active 53.4 pmol/L

Please note change of reference range 23 Oct 2022

(Range: 37.5 - 188)

Vitamin D 95.7 nmol/L

Total 25(OH) vitamin D < 25 nmol/L is deficient.

Total 25(OH)D of 25-50 nmol/L may be inadequate in some people.

Total 25(OH)D > 50 nmol/L is sufficient in most individuals.

Total Vitamin D level >250 nmol/L - indicates potential for toxicity.

Please note change of reference range 23 Oct 2022

(Range: 50 - 250)

Thyroid Hormones

TSH 1.480 mIU/L (Range: 0.27 - 4.2)

Free T3 4.0 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 21.8 pmol/L (Range: 12 - 22)

Autoimmunity

Thyroglobulin Antibodies 32.10 kIU/L (Range: 0 - 115)

Thyroid Peroxidase Antibodies X 174.0 kIU/L (Range: 0 - 34)

[Regenallotment]

I took a methylated folate supplement alongside a methylated b12 and Thorne Basic B complex for a few months and re-tested. Levels rose well as did sense of wellness and absorption of T4/T3. Then just took B complex for a bit and now alternating days.

It seems many of us have a MTHFR gene mutation that means we struggle to absorb/convert/make use of other forms E.g. folic acid. Having the Methylated variety seems to work.

I found my mutation searching through my Ancestry DNA records from years ago on the laptop.

🌱

[Syrupafigs in reply to Regenallotment]

thanks

[SlowDragon Administrator]

was this test done early morning, ideally just before 9am, only drinking water between waking and test and last dose levothyroxine 24 hours before test

Was last dose 100mcg or 50mcg

Which brand is 50mcg and which brand 100mcg

Why not take 75mcg daily?

[Syrupafigs in reply to SlowDragon]

Test was done 09-00hrs, only drinking water and last dose of thyroxine was 100mcg takrn 24hrs before test. the brand for the 100mcg and 50 mcg is accord and I tried 75mcg Teva which I could not tolerate

[SlowDragon Administrator in reply to Syrupafigs]

Looking at previous post you take Accord and Accord don’t make 25mcg tablets

Suggest you cut a 50mcg tablet in half to get 75mcg daily

Save the other half for next day

[SlowDragon Administrator]

Folate - Serum X 8.1 nmol/L (Range: 8.83 - 60.8)

Vitamin B12 - Active 53.4 pmol/L

Folate obviously deficient

Is GP prescribing folic acid?

But you should wait until started B12 injections (48 hours ) or daily B12 supplement (week after) before starting folic acid/folate supplement

Note that improving folate when B12 is very low is not a good idea. Taking folate before B12 is good enough can lead to severe neurological problems.

en.wikipedia.org/wiki/Subac...

It is vital if you intend to supplement both B12 and folate that B12 is started a week before the folate.

[Syrupafigs in reply to SlowDragon]

thanks have you got any info on vitB 12 and folic acid

[SlowDragon Administrator in reply to Syrupafigs]

Low B12 symptoms

b12deficiency.info/signs-an...

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

if GP doesn’t prescribe B12 injections after MMA testing

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and after a week add folic acid prescription

once you finish prescription Folic acid look at adding a separate vitamin 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

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

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...

Low folate

Once prescription folic acid completed

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

healthline.com/nutrition/fo...

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. Or try ebay

Other options

healthunlocked.com/thyroidu....

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 folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

How other member saw how effective improving low B vitamins has been

healthunlocked.com/thyroidu...

[Syrupafigs in reply to SlowDragon]

thanks

[SlowDragon Administrator]

You have Hashimoto’s

Have you had coeliac blood test

If not get tested, assuming you’re not already on strictly gluten free diet

[Syrupafigs in reply to SlowDragon]

I have had a coeliac blood test which was neg and i am not on a gluten free diet

[SlowDragon Administrator in reply to Syrupafigs]

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels as seen by your low B12 and folate

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.

Most common by far is gluten.

Dairy is second most common.

A trial of strictly gluten free diet is always worth doing

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies

As your coeliac test is negative you can now consider trialing strictly gluten free diet 

Trying gluten free diet for 3-6 months.

If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial

Hashimoto’s and leaky gut often occur together

[Syrupafigs in reply to SlowDragon]

thanks

[Syrupafigs in reply to SlowDragon]

Hi SlowDragon, I have tried to save all the replies but cant, is there a way I can save them , thanks

[tattybogle in reply to Syrupafigs]

you can't save individual replies syrupafigs , but you can save a whole post including all it's replies by clicking on :

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Slightly off topic but I hope you don’t mind me smiling at your user name 😉

‘Syrupafigs’ as my dear mum called it played a significant part in my childhood. Every Friday night involved a bath, a hair wash, ‘Syrupafigs’ and a torturous session with the ‘nit comb’ - whether we needed it or not.

If we were lucky, we were allowed to stay up to watch “Dr Kildare” 🙂