What to push for next: Hypothyroidism and taking... - Thyroid UK

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What to push for next

lostatsea2 profile image
10 Replies

Hypothyroidism and taking 100mcg of Levothyroxine for years

Recent blood results showed low Folate and D. Doctor prescribed Folic acid for 3 months. B12 was "in range"

Been taking Folic and D3 for 10 days and feel like I'm going backwards.

My symptoms include feeling like a tablet is stuck in my throat, lower leg muscle twitching, hoarse voice that quivers occasionally, general malaise like I'm not really listening to people and the occasional blurred eyesight and feeling that the light has changed. Sometimes my heart rate increases on a slow walk (not like me)

Ive been gluten and dairy free since April. Not sure the folic acid agrees with me.

Due an appointment with the GP in 10 days. Beyond blood tests, I'm not sure they know what is the best course of action.

Am I better off ditching the folic acid and just taking a B complex and what shall I push for at the GP appointment?

Thanks

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helvella profile image
helvellaAdministratorThyroid UK

What dose of folic acid?

There seems to be a theme where GPs prescribe 5 milligrams of folic acid but the person does not tolerate such a high dose, at least, not every day or for a long time.

B12 being "in range" is not reassuring! The reference interval (range) goes so low that many are very ill by the time they get there. Find out that number and the reference interval that applies.

It is always concerning that your B12 could be low, or very low, within reference interval, but you have started on folic acid. It is always advised that if you are low in both, you should always start B12 treatment before folic acid. Even a couple of days!

lostatsea2 profile image
lostatsea2 in reply to helvella

5mg Folic Acid (Almus)

B12 was 491 pmol/L range was 145-569

Vitamin D (25 OH) was 62

Folate 6.50 range 8.83-60.8

in reply to lostatsea2

5 mg dose is not good news. I was prescribed that once and tolerated it only a week. Insomnia and anxiety.

Vitamin D is a little low. Mine has just come back at 70 nmol/L. It was 90. Now supplementing to increase. 1000 IU will increase Vitamin D by 10 nmol/L so. I’m currently taking 2000 IU to get back to my baseline.

Have supplemented Folate with 200 mcg dose and my Folate has increased to 2x range in 6 months. Have now stopped supplementing that.

Jazzw profile image
Jazzw

Reading your other recent posts, I see you’re sensitive to lactose. Does the folic acid tablet have lactose in it?

lostatsea2 profile image
lostatsea2 in reply to Jazzw

Yes they do contain lactose. Very helpful pharmacist said that they could not get lactose free Folic acid tablets.

SlowDragon profile image
SlowDragonAdministrator

Request ultrasound scan of thyroid

Generally don’t start 2 supplements at once as you can’t tell which is causing the issue

Perhaps halt vitamin D for week or so

Perhaps then try vitamin D mouth spray

If it’s folic acid causing the issue get a methyl folate supplement instead…..eg Jarrow 400mcg

And add a separate B12 supplement (ideally you would have started B12 first before adding folic acid)

Lalatoot profile image
Lalatoot

Improve your vitamins first.

Check you are taking things well away from your levo dose. Try taking your levo dose at night. Try splitting your levo dose. Both these two things have helped others absorb or process levo better.

Then if symptoms persist get sets of blood tests done over a period of time that include tsh, ft4 and ft3. You may have to do these privately. The results will indicate whether you are on a high enough dose of levo and, if you are, whether you are potentially a poor convertor and might benefit from the addition of liothyronine t3.

lostatsea2 profile image
lostatsea2 in reply to Lalatoot

Based on the symptoms, which vitamins should I increase first?

My recent blood results
SlowDragon profile image
SlowDragonAdministrator

Jarrow Methyl folate is lactose free

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

Ideally you would start with a separate B12 supplement first, then add folate week later

And vitamin D couple weeks later

after a month or so on daily folate, should be able to change to a daily vitamin B complex

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 separate B12 supplement and then add folate a week later

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...

Once you change to supplementing a good quality daily vitamin B complex, 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....

Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day.

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 separate folate supplement again that week

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

lostatsea2 profile image
lostatsea2 in reply to SlowDragon

Excellent post thank you

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