Latest results..... what am I doing wrong?

[Horsecrazylady79]

These are my latest results, I will be restarting my B12 injections as my symptoms have come back and that made me want to retest. The levels have dropped quite a lot and quite quickly considering the last time I had them done they were well over 2000! I'm speaking to my Endo tomorrow as I have a phone consult. Currently taking 125mg T4 and 20mg T3 split in two doses.

TSH 0.01 mIU/L (0.27 - 4.20) -6.6%

Free T4 (fT4) 16 pmol/L (11 - 25) 35.7%

Free T3 (fT3) 5.3 pmol/L (3.1 - 6.8) 59.5%

T4:T3 Ratio 3.019 

Folate - Serum 2.1 ug/L (3.0 - 5) -45.0%

Ferritin 21 ug/L (15 - 300) 2.1%

Potassium  4 mmol/L (3.5 - 5.3) 27.8%

Sodium 141 mmol/L (133 - 146) 61.5%

Serum B12 is 549 ng/L (180-900) 52.2%

Also take Vit B complex, Vit D3 +K2, and Magnesium.

Blood test taken following all usual protocols.

[TiggerMe]

Desperately need to add some folate to your supplements as this leads to oversized red blood cells which reduces the oxygen carrying capability and leads to fatigue, muscle weakness.... need a full iron panel to see if you can safely add some iron, the body doesn't retain B12 or folate for long so you need to keep topping them up... red blood cells take 150+ days to regenerate

Just looking back at your last post a year ago and your folate and iron were flagged up then

[Horsecrazylady79 in reply to TiggerMe]

I do take a folate supplement. I take Jarrows Complete B supplement. I will ask my endo tomorrow for a full panel, this time round I only had ferritin and folate done. Folate- 2.1 ug/L (>3)

Ferritin - 21 ug/L (15-300)

My FBC indicates anaemia though which isn't surprising as I've suffered on and off my whole life and it runs in my family, my mother needed several iron transfusions when she was having me as I kept taking hers 😂

My MCH is under range and my MCV is literally barely in range 26.3pg (27.0-33.0) and 83fL (80-100) respectively.

Lookiing at that same post, my B12 was over 2000 a year ago, I only stopped SI about 8 months ago as I was finding it difficult to get them from Germany at the time. Despite taking supplements, my B12 shouldn't have tanked that quickly or that much in 8 months! It says on the results that my current levels should be adequate for 2 years, but given that it's dropped 1500 in a third of that time frame already doesn't bode well. My son is currently living in Germany so he's ordered me some and is sending them over to me. Soon as I get them I'll be restarting them.

Thank you for your reply, I appreciate it.

[TiggerMe in reply to Horsecrazylady79]

Sounds like you have pernicious anaemia which means you don't absorb B12 through the stomach which is why the injections are needed hence yours dropping so quickly.... Have you had a test for intrinsic factor?

I thought the ampoules were freely available here, worth going to the pernicious anaemia forum and asking there

[Horsecrazylady79 in reply to TiggerMe]

I tested negative for IF a few years ago, but that doesn't necessarily rule out PA, my grandad had it for over 60 years and was IF negative for most of it! I was diagnosed with a Functional B12d several years ago hence the original reason for SI.

[TiggerMe in reply to Horsecrazylady79]

If diagnosed do you not qualify for regular free jabs from the NHS? Must admit I don't know much about it 🙃

[Horsecrazylady79 in reply to TiggerMe]

You'd think but no, because my initial levels were just over the bottom of the normal range Haematology wouldn't even sign off on a trial!! It was Prof. Wass that diagnosed me. I went to see him privately as hes the top endocrinologist in the country and is a leading figure on Addison's Disease which I was really struggling to get under control at the time.

[Jaydee1507 Administrator]

Which B complex are you taking?

You may have MTHFR genes and need extra folate as yours is currently deficient.

Did you time your Levo & T3 according to the recommended protocol?

Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).

Ferritin is deficient. NICE guidelines state that a level of 30 or less is deficient. GP should prescribe supplement if they retest but you can also buy a supplement. Many in this group do well with this product:

threearrowsnutra.com/en-uk/...

We need all key vitamins at OPTIMAL levels for our thyroid hormone to work well.

Your thyroid results show you need a little more Levo.

[Horsecrazylady79 in reply to Jaydee1507]

Which B complex are you taking? I'm currently taking Jarrows Complete B

You may have MTHFR genes - Is there a way to get these tested?

and need extra folate as yours is currently deficient. Do you mean in addition to Jarrows?

Did you time your Levo & T3 according to the recommended protocol? Yes, I always follow the protocols when doing my bloods unless they're sprung on me, which this one wasn't.

[Jaydee1507 Administrator in reply to Horsecrazylady79]

Are you taking the Jarrows B complex daily? It does have 400mcgs folate so you could buy a separate 400mcgs folate to add to it. Yes, in addition. Retest folate after 3 months or so to check you are taking enough then.

The Jarrows B complex has a relatively lowish dose of B12. Would recommend changing that to something like Thorne Basic B which has 4x the amount of B12.

You can test for MTHFR, there's probably different ways but I took my raw data from Ancestry DNA and uploaded it to a functional analyser: mthfr-genetics.co.uk/DNA/ab...

thorne B contents

[Horsecrazylady79 in reply to Jaydee1507]

Yes I take the Jarrows daily, I'm aware the low B12 in this make so I also take the clean B12 supplement from British Supplements. Apologies, didn't add that!

british-supplements.net/pro...

I'll have a look at that link, thank you.