Advice please re B12 to supplement or not

[lolajone]

Following covid in July I have been experiencing tingling in feet and hands. I've left it until now in the hope it would resolve and while it has lessened it is still there. I currently take 100mg t4 and 10ug t3.

GP blood test results 17 August :

HbA1c 34mmol/mol (20-41)

TSH 1.46 mu/L (0.3-4.2)

ferritin 183ug/l (28-200)

serum B12 431 ng/l (180-640)

folate 6.9ug/l (3-20)

adjusted Ca 2.42 mmol/l (2.2-2.6)

phosphate 0.81 mmol/l (0.8-1.5)

It was suggested on forum that should wait for a couple of months and retest so Monitor my Health results from 2 October are:

D3 75 38-180

TSH 0.61 0.27-4.2 mU/L

T4 19.4 12 - 22 pmol/L

T3 4.2 3.1 - 6.8 pmol/L)

Ferritin 206ug/l 10-400

Active B12 69 pmol/l 38-210

Folate 13.3 ug/l 3-25

HbA1c 37 mmol/mol <42

The active B12 looks low. Does anybody know about active B12? Does anybody have any thoughts on whether I should try and get further testing for B12 or just start supplementing?

Besides the tingling I am exhausted, constantly - symptoms include fatigue, brain fog aching joints, weak muscles, itching, burning legs in bed, poor sleep, breathlessness.

Any thoughts would be gratefully received.

[SlowDragon Administrator]

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test

Do you normally split your T3 as 2 x 5mcg doses

Assuming last dose 8-12 hours before test…..Your results suggest you may need increase in T3

FT4: 19.4 pmol/l (Range 12 - 22)

Ft4 74.00% through range

FT3: 4.2 pmol/l (Range 3.1 - 6.8)

Ft3 only 29.73% through range

What vitamin supplements are you currently taking

[lolajone in reply to SlowDragon]

the only supplements presently are D3 which has been a bit sporadic before the test so I was surprised at the level it was. Also magnesium glycinate ans I’m post parathyroidectomy. I’ve just started phosphate again ans that keeps dropping . I’m holding off anything else until I get a steer re the B12.

Last dose of t3 was about 16 hours prior to the test. Test was first thing with just water etc. T3 10 in morning not split.

[SlowDragon Administrator in reply to lolajone]

So retest with last 5mcg dose 8pm

Or splitting as 5mcg waking, 2.5mcg mid afternoon and 2.5mcg 8pm

[Bearo]

Just attempting to bump your post as your question hasn’t been answered yet!

[lolajone in reply to Bearo]

Thank you

[Jaydee1507 Administrator]

Active B12 should be above 75 so yours is a little below.

Its usually recommended to take a B complex to help keep all your B vitamins in balance. I will list some choices for those further on.

If you took the vit D regularly your level would obviously be better. Its easy to forget sometimes I know! With vit D you can take a bit extra for missed doses to catch up.

Optimal for vit D is 100-150.