First time posting here with questions

[shirlzoni]

Hello,

I was wondering how to tell if you need b12 injections when you take oral b12 and your serum b12 always comes out looking great? I haven't had it tested recently but past tests always come out way over the range. Anyway, I saw a post by @Marz in which she said that she takes b12 due to having had bowel surgery and I had the same surgery about 10 years ago (as well as having Hashi's) so I'm wondering if that means my ability to absorb b12 is compromised? My surgeon said that it wouldn't be but I can't help but wonder why I'm so tired all the time despite labs looking good.

Here are some recent labs I've had done in the last year. They didn't do a folate test and I didn't know to ask for that.

10/10/22 Vitamin B12 838 pg/ml (>= 200 pg/ml)

4/23/23 Vitamin D 80 ng/ml (20 - 79 ng/ml)

7/28/23 Ferritin 4 5 ng/ml (22 - 291 ng/ml)

12/23/23 TSH 1.2 uIU/ml (0.4 - 5 uIU/ml)

12/23/23 Free T4 1.3 ng/dl (0.8 - 1.7 ng/dl)

12/23/23 Total T3 81 ng/dl (50 - 170 ng/dl) *Dr will not order a free T3 only a total)

12/23/23 hgb A1C 5.6 (<= 5.6)

I take a multivitamin with B12 and an iron supplement that also has B12 because my ferritin usually hugs the bottom of the range. It took 2 years to bring my ferritin up from 29 to 45. I see an endocrinologist privately who treats my Hashi's and he recommended iron infusions but I can't get it ordered under my insurance because my blood counts and hemoglobin are in the normal range.

These thyroid labs were done when I was on 50 mcg of Tirosint but my endo recently raised my dose to 75 mcg and I guess he's hoping I'll be able to tolerate some T3 medication at some point. I don't tolerate NDT at all so that's off the table. BTW, I take my thyroid labs fasting 24 hours after my last dose of Tirosint.

And to answer your question, Marz, my hubby has had all the same tests done as well as folate and his results are all in the normal range.

Thanks in advance to all who read this and share their thoughts.

Best,

shirlzoni

[Buddy195 Administrator]

Welcome to the forum shirlzoni,

I’m sure members knowledgeable in B12 injections will be along soon to offer advice.

To alert a member it’s @ followed by their name / their name will turn blue when selected

 Marz

It’s helpful to complete your profile & share your thyroid journey with members - when diagnosed/ symptoms/ medication etc.

[shirlzoni in reply to Buddy195]

Thank you, Buddy195. Your welcome and instruction about alerting are much appreciated. I put the @ sign in front of Marz but it didn't turn blue so not sure what happened there. Thanks for alerting her for me!

[Marz]

Once supplementing B12 your results will be skewed and look good... Tests reveal the B12 in the blood and not in the cells where needed..

Will write more later 🌻

[shirlzoni in reply to Marz]

I’m guessing this means you need to stop taking the b12 for some time prior to testing? I wouldn’t have done that so I can see now that my serum b12 tests are inaccurate.

[Marz]

Stopping B12 is not an option for many as the return of symptoms can be difficult to cope with. It looks as if you had the Active B12 Test which indicates the amount of B12 available to reach the cells. 75 is the suggested level nentioned here.

Folate/B9/Folic Acid works with B12 and a deficiency can expose many symptoms...

Taking a multi-vit is not considered a good move especially if it contains calcium - which blocks the iron uptake and other nutrients. Take well away from Thyroid meds. VitC helps iron absorption.

You mention hubby's results are in the normal range ? Are they optimal or bumping along around the bottom/middle of range ?

[shirlzoni in reply to Marz]

Hi Marz thanks for the info. Guess I’ll have to rethink my supplementation if calcium is a no no. I always take it in the evenings so it’s away from my thyroid medication but that’s when I take my iron pill too so maybe I’m not getting all the iron. The iron pill has folate and vitamin c along with the iron and b12 so maybe that’s all I need.

Here are hubby’s latest nutrient tests.

1/14/23 Folic acid 11.6 ng/ml. (>= 4 ng/ml)

1/4/23 Vitamin B12 359 pg/ml (>= 200 pg/ml)

He also takes a low potency multivitamin and mineral supplement as recommended by his hematologist for chronic anemia. Can’t take iron as it’s thought to be problematic in PD.