Advice on Thyroid Test Results.B12 and Folate Low - Thyroid UK

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Advice on Thyroid Test Results.B12 and Folate Low

Strollingrose profile image
13 Replies

Hi

I have been advised by GP to take statins.Serum Total Cholesterol 6.9

I have Hashimotos and not keen on starting Statins. This concern has been covered by others on this site and very grateful for the knowledge I have gained.

My concerns is that I have a lot of painful symptoms that may be causing my high cholesterol so I have taken a thyroid test with Blue Horizon

I am concerned with 2 results that are outside normal range and I feel are possibly the cause of a lot of painful codtions that I felt were due to my Throid disease

Ferritin. 6.0

Serum Folate. 6.63

Active B12. 47

Cortisol (Random) 549.0

I was diagnosed with Hashimotos by Endocrinologist In 2014 although underactive thyroid since 20s . I am aged 67

I have a blood test every 12 months for TsH only

I am seeing my Gp this afternoon and I don’t feel confident.

I have looked back on past B12 results and they are all borderline line or below range and all tests are always ticked off by doc as normal even though lab comments Pernicious Aneamia!

I would be grateful for points I need to make that will help to get the right help .

Thank you

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Strollingrose profile image
Strollingrose
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13 Replies
greygoose profile image
greygoose

My concerns is that I have a lot of painful symptoms that may be causing my high cholesterol

Not sure what you mean by this - how can symptoms cause high cholesterol, painful or otherwise? High cholesterol is more than likely due to low FT3. Cholesterol is made in the liver, and the liver does its best to keep the level steady. But when T3 is low, the body cannot process cholesterol correctly and it tends to build up in the blood.

Check out the blog by Dr Malcolm Kendrick and his book The Great Cholesterol Con:

amazon.fr/Great-Cholesterol...

He explains it all better than I can - although, unfortunately, he doesn't mention thyroid.

For help with B12 and Pernicious Anemia try asking on the PA forum:

healthunlocked.com/pasoc/po...

:)

Strollingrose profile image
Strollingrose in reply togreygoose

Thank you . I will read the blog re cholesterol. I am hoping that My GP will further testing for PA . My appointment is in a couple of hours.

greygoose profile image
greygoose in reply toStrollingrose

Good luck! :)

SlowDragon profile image
SlowDragonAdministrator

With terrible vitamin levels you likely have low Ft3

Low Ft3 results in vitamin levels dropping further

Low Ft3 also results in higher cholesterol

What was vitamin D result

Ferritin. 6.0

Serum Folate. 6.63

Active B12. 47

Take these results to GP

Are you vegetarian or vegan

Ferritin is deficient if below 30

You need full iron panel test for anaemia including ferritin

Likely iron supplements, possibly iron infusion

B12 and folate are far too low.

I have looked back on past B12 results and they are all borderline line or below range and all tests are always ticked off by doc as normal even though lab comments Pernicious Aneamia!

Request full testing for Pernicious Anaemia

Low B12 symptoms

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

NICE guidelines on B12 and testing

healthunlocked.com/redirect...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

A week later add a separate vitamin B Complex 

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

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

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

cytoplan.co.uk/shop-by-prod...

In-depth article on different forms of B12

perniciousanemia.org/b12/fo...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

perniciousanemia.org/b12/le...

And why aiming to keep B12 over 500 recommended

perniciousanemia.org/b12/le...

Great reply by @humanbean on B12 here

healthunlocked.com/thyroidu...

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

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 supplements

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need separate methyl folate couple times a week

Post discussing different B complex

healthunlocked.com/thyroidu...

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 can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 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 a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

Strollingrose profile image
Strollingrose in reply toSlowDragon

Sorry missed these results

vitamin D (25 OH). 86

Magnesium 1.0. I take supplements

CRP1.35

SlowDragon profile image
SlowDragonAdministrator in reply toStrollingrose

So look at increasing vitamin D a bit to maintain nearer 100nmol

SlowDragon profile image
SlowDragonAdministrator

so I have taken a thyroid test with Blue Horizon

What are thyroid results

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)

is this how you did your test?

How much levothyroxine are you taking

Do you always get same brand levothyroxine at each prescription

Exactly what vitamin supplements are you currently taking

With Hashimoto’s and very poor vitamin levels you should also have coeliac blood test BEFORE trailing strictly gluten free diet (if not already GF)

as per NICE Guidelines

nice.org.uk/guidance/ng20/c...

SlowDragon profile image
SlowDragonAdministrator

Apologies….didn’t realise this was your first post

Welcome to the forum

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.

Most common by far is gluten.

Dairy is second most common.

A trial of strictly gluten free diet is always worth doing

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies

Assuming coeliac test is negative you can immediately go on strictly gluten free diet 

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially) 

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial

With loads of vegan dairy alternatives these days it’s not as difficult as in the past

Post discussing gluten

healthunlocked.com/thyroidu...

Recent research in China into food intolerances with Hashimoto’s

healthunlocked.com/thyroidu...

Strollingrose profile image
Strollingrose in reply toSlowDragon

My mother was a celiac and had her thyroid removed in her late twenties.

Strollingrose profile image
Strollingrose

tThanks for your comments . I am going to follow up and read your links .

I did not enter my full Thyroid results from lab. Which were not commented on. So I assume Normal.

TSH. 1.59

Free T4 20.8

Free T3 3.8

T4 Total 121.0

Anti- Thyroglobulin Abs 35

Anti- Thyroidperoxidase abs 12.6

If this helps.

SlowDragon profile image
SlowDragonAdministrator in reply toStrollingrose

Free T4 (fT4) 20.8 pmol/L (12 - 22) 88.0%

Free T3 (fT3) 3.8 pmol/L (3.1 - 6.8)

Ft3 only 18.9% through range

was test early morning and last dose levothyroxine 24 hours before test

Assuming yes…..shows terrible conversion rate …..hardly surprising considering how low your vitamin levels are

Looking for Ft3 to improve to at least 60% through range

You missed TPO result off

Do you always get same brand levothyroxine at each prescription

As your mum was coeliac you should have been tested at her diagnosis……and certainly at your own diagnosis of Hashimoto’s……..were you?

Work on improving low vitamin levels

Get coeliac blood test …..if negative you can immediately trial strictly gluten free diet….3-6 months minimum

Strollingrose profile image
Strollingrose in reply toSlowDragon

I took test 7.30am on empty stomach and 24 hours since last dose.

I am on Levothyroxine 150 microgram daily

I always seem to have the same brand, but I cannot remember the name as I have a different t brand at the moment Hillcross.

I have now seen doctor, locum So I had to go through my medical history!

She will test my folate and associated tests including coeliac. She said my Thyroid tests in normal range so I will probably need to see Endocrinology if I wanted to discuss this more.

I will work on improving vitamin levels .

I feel the pressure to start on statins as last weekend I had dangerously high BP and chest pain and ended up in AE. ECG ok and BP now down to usual readings . All very stressful.

At least I am now more informed and if I do start statins I will make sure that my thyroid and vitamin levels are all functioning at optimal levels so I may reduce / eliminate statins.

Tina_Maria profile image
Tina_Maria in reply toStrollingrose

Even without seeing the reference ranges, it looks that your T4 is at the high end and your T3 is very low. As others have commented, if your T3 is low, you would feel awful. There is also a wide gap between your T4 and T3 levels, which indicate that you don't convert the T4 you are taking (in the form of levothyroxine) to the active hormone T3.

The problem with reference ranges is, that GPs generally do not care where in the reference range your results are. As long as they are somewhere within the ranges, you are 'normal' and their job is done. Did he actually ask you how you feel with these results?

Most people on replacement therapy feel best if their TSH is around 1 or slightly below, and both the T4 and T3 between 60 and 75% through the range. I think that you may need an addition of T3 to your therapy to get your T3 levels higher. And as someone else has pointed out, the low T3 is responsible for your higher cholesterol level, as you have not got enough active thyroid hormone to properly metabolise your lipids. Once your levels of T3 go up, the cholesterol will come down as a result. Sadly, GPs will rather give you statins than address the real underlying problem, which is a lack of active thyroid hormone (T3).

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