First of all, I have to say thank you. This is my first time posting, but I've been lurking around here for a while now and I have already learnt so much from this forum!
I was diagnosed with hypothyroidism in Nov 2021 and put on 25mcg levothyroxine. It has been a slow battle to get doctors to increase my dosage. I've been on 75 mcg since May, and was not too bad over the summer (not perfect, but better than I'd been in a long time) before crashing out after a very stressful process of moving in September. I've made some small improvement since then, but mostly I'm back in achy, sore, exhausted territory and feeling pretty crap with no energy to go out and meet new people in my new town!
Got tests at the end of November
TSH 2.53 (0.38-5.33)
ESR 51 (5-25)
Vitamin D 19.6 (14-100)
Iron 84 (49-151)
Ferritin 87 (10-120)
Transferrin 223 (200-360)
Transferrin saturation 29.7% (17.1-30.6)
B12 1076 (115-513)
Folic Acid 8.8 (3.1-19.9)
I had a battle with the doctor who gave me the results (a substitute unfortunately) and he begrudgingly increased my dose to 88mcg. I am aware this is still probably not enough, but I hope I can get another increase in a month or two.
Doctor dismissed vitamin D but I decided to immediately start supplementing 4000UI, my aim is to get levels up to 60-80 range. I will retest privately next year if need be.
My questions are regarding B12, iron and folate.
I have been taking B12+B complex sublingual drops (stopped four days before blood draw). Doctor told me to stop. I believe this is incorrect as B12 water soluble and a maintenance dose may be needed? I was going to continue, but maybe at a lower dose.
Folate I believe is lower than optimal? I've read here before it should be top half of range. What is the best way in my case to supplement folate? How much and for how long?
Possibly the most complex part is the iron. Last time I tested was August last year and the results were:
Iron 92 (60-180)
Ferritin 41.2 (10-120)
I have been supplementing on and off with iron this year as symptoms were worse after period, but I was cautious about overdoing it. My new results have shown serum iron drop a little and ferritin increase. The thing is that my inflammation marker is also increased, so I believe that this may falsely raise ferritin too? Because of all this not sure if it is a good idea to supplement iron or not. And the best way to go about it.
I hope I've included necessary info as succinctly as possible! Thanks for any advice you can give me regarding all this.
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catpotter44
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Thank you so much! The support on this forum really is amazing <3
Profile updated, for some reason I had the info on private.
Yes, I guess it's about time for some private testing again. It's just a matter of affordability, but I was going to test vitamin D anyway. Maybe not worth testing until thyroid optimized though? Will vitamin levels increase once medication optimised? And does this mean I shouldn't worry as much about supplementation?
So, I don't need to take B12 to maintain the level? Will a b-complex be adequate for folate or should I take a specific folate supplement?
Regarding iron panel, what other markers are necessary? I have Serum iron, ferritin, transferrin and transferrin saturation (as well as haptoglobin, which I'm not sure if it's relevant). These four seem to be the standard practice in the doctor's surgery here.
I already eat quite well, meat, leafy greens, seeds, lots of veg etc, but I suspect my absorption may be low due to low thyroid
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
Yes, you had the full iron panel, but no one has commented on it……I don’t have much knowledge about iron, but your hemoglobin, which can indicate anaemia, is right at the bottom of the range.
If you still have some questions- e.g is my iron ok? Does this look like anaemia? you could start a new post. Sometimes things get missed.
Thanks Bearo, good idea, I will make another iron specific post. I was thinking the same as you, that although 'in range' it's near the bottom. But I'm not sure what I need to do.
The experts on here will advice you but I just wanted to let you know that the kidneys and liver have B12 storage areas which can store for up to 3 years. Any xs beyond that will be peed out because B12 is water soluble. However you may be advised to stop b12 for now and keep an eye on your levels.
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Yes, I think I'm going to continue with a different b-complex that doesn't have the extra b12, just a normal level.
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