The Vitamin B puzzle

[ainslie]

I have been wondering about Vit B and my thyroid tests. It seems that opinions vary on how long before a thyroid blood test you should stop B vits with Biotin, it seems to vary from 2-7 days. I read somewhere the Biotin can lower or raise FT3. If thats the case then stopping B vits at 2 days or 5 days or 7 days prior might/should presumably give different lab results? ie different at each of those ie 2 days/5days/7 days.

Perhaps more importantly if B Vits or Biotin affect the thyroid lab results (we seem to advocate on here that B vits are important) then are the labs going to be accurate if Biotin /B vits are stopt 5-7 days before because normally we take B vits every day so presumably the theoretical FT3 reading will be different if we take B vits on a normal day. I hope I expressed my puzzle accurately enough.

Has anyone put this to the test, ie take B vits even the morning of the test as normal or maybe 24 hrs before and do a blood test for FT3etc and then stop the B vits/Biotin and test again in say 7 days to compare?

[greygoose]

Has anyone put this to the test, ie take B vits even the morning of the test as normal or maybe 24 hrs before and do a blood test for FT3etc and then stop the B vits/Biotin and test again in say 7 days to compare?

I don't think that would give you any coherent answers because biotin may or may not give a false high FT3 - or it may or may not give a false low FT3 - or a false high/low TSH/FT4 or any other test you care to mention. It's effect is totally unpredictable but is only a problem with test that use biotin in the testing process. I don't think it's an experiment that any one individual could do with any success. It would have to be done in a laboratory, under controlled conditions.

[ainslie in reply to greygoose]

Mmmm, if that’s the case it rather questions how accurate these blood tests are for us who normally take B vits/biotin. Maybe Peatfield had a point.

[greygoose in reply to ainslie]

Of course, it does depends how much biotin you're taking. The biotin you would find in your average B complex is said not to be enough to cause a problem.

But, then again, when you get down to it, how accurate are blood tests anyway? There's a huge margin of error.

[ainslie in reply to greygoose]

its 50mcg D Biotin in Solgar B complex

[Noelnoel in reply to ainslie]

Maybe Peatfield had a point

What point was that?

[ainslie in reply to Noelnoel]

That blood tests are not as useful as temps, pulse Achilles heal etc, ie thyroid in cells as opposed to blood

[Noelnoel in reply to ainslie]

For me that’s been true. I knew something was going right when my temp rose a whole degree and at which point I finally began to shed weight

[Nacoya in reply to Noelnoel]

I found the same - finally got to a good level with levo, temp started to go up, was able to lose weight.

[TiggerMe Ambassador]

It's more of an issue with people taking high doses of Biotin which the B complex's we suggest don't so a couple of days is fine, as for the skewed results that's due to it interfering with the test rather than the biotin in the blood making a big difference to daily levels

Link to 🍄's Blog... helvella.blogspot.com/p/hel...

[ainslie in reply to TiggerMe]

okay thats interesting about its the biotin in the test, that answers a few bits

[waveylines in reply to TiggerMe]

Not so in my case. I had an unexpected blood test when on Thornes Basic B complex which has biotin in it. My Ft3 and Ft 4 were through the roof. Made a massive difference. Hospital were not happy and sent a letter to my GP telling them I was over replaced on my thyroid meds. I complained and the test was repeated a week later having stopped the Thornes basic b complex and they came back with their usual ranges. My GP was aware of this issue as was my surgeon. Pre op weren't. My surgery went ahead as planned.

However an unpleasant nhs endo a year later quoted this high reading back at me a and we had a whole "conversation" about it.

If you Google it comes up as a known connection. It's not all the b vitamins its biotin. I've since had one Endocrinologist suggest I stop taking it for 3 weeks.

I do need a b vits supplement as I also need b12 jabs. Lately I've been exploring a less potent complex as have been gf for 2 years and am absorbing better.

There is some awareness of this on the NHS:-

barnsleyhospital.nhs.uk/pat...

[TiggerMe Ambassador in reply to waveylines]

So with Thorne containing 400mcg 2-5 days ought to have been enough like you say after a week everything was back to normal, if you were tested right after taking it then your levels would have been higher

[waveylines in reply to TiggerMe]

They were high. The blood test was mid afternoon....un expected. If I recollect correctly my Ft 4 said 32 (range max was 21) can't remember ft3. I would definately not take any biotin for a week before a blood test. An endos recommrndation of 3 weeks isn't practical for me but interesting he thought that. Realky wanted me off biotin all together.

Of course everyone is different....

I thought Rotherhams Hospitals descriptions of the different assays and their effects of coping with biotin was really interesting.

[TiggerMe Ambassador in reply to waveylines]

It would seem Randox aren't effected, they don't request withholding biotin as their machines don't use it...

randox.com/tag/biotin/

[waveylines in reply to TiggerMe]

Indeed that's why I found that the link I put up interesting. I'd dtill be wary though. Eg b12 testing with new machinery that's come in is now less accurate. New machinery means they can test even larger barches of blood samples then before. The b12 assay is known to have been effected by this. Personally just stopping Biotin seems a way of just ensuring your sample isn't affected.

[ainslie in reply to waveylines]

Interesting, can you remember how much biotin was in your B complex

[waveylines in reply to ainslie]

Please look further down the post. 😊

[ainslie in reply to waveylines]

Got it thanks👍

[SlowDragon Administrator]

Depends on how much biotin you are taking how long before test it’s recommended you stop taking it

If you’re taking vitamin B complex, we recommend stopping 3-5 days before and instead while not taking B complex ………a daily methyl folate instead and…..if B12 was low at previous test, also taking a daily B12

[ainslie in reply to SlowDragon]

its50 mcg of D biotin in Solfar B Complex 50. Ah so thats important, ie to methyl folate and B12 , presumably they affect the results too

[SlowDragon Administrator in reply to ainslie]

Yes if you stop vitamin B complex …..and don’t take a daily folate instead then folate level can drop quite quickly

[waveylines in reply to ainslie]

No methylfolate doesn't affect blood tests.....just biotin. Methylfomate daily to replace b complex whilst you stop it due to biotin content one week before blood test. (Or if u want to follow what an endo said to me 3 weeks stopping biotin!)

[ainslie in reply to waveylines]

Ok interesting but why replace with Methylfomate if doesn’t affect blood tests?

[waveylines in reply to ainslie]

Biotin is in the b complex so needs the b complex needs to be stopped for one week because Biotin does affect blood test results. In the b complex is methylfolate. MethylFolate can drop quickly once supplementation is stopped via the b complex. So you take methylfolate whilst the b complex is stopped.

Methylfolate will not affect blood test redults

[ainslie in reply to waveylines]

Ok thanks, what dose of methyl folate should we take

[waveylines in reply to ainslie]

The same as in your own brand of b complex if you need it. If your fine without for a week thats fine. I become tired and weak but I also have high frequency b12 jabs (nhs prescribed) so likely the issue.

[ainslie in reply to waveylines]

oky thanks

[ainslie in reply to waveylines]

what is the problem if we are not getting Methylfolate for the week before the blood test (while stopping B complex) if it as you say doesnt affect blood tests, kinda confused there a bit

[waveylines in reply to ainslie]

The methylfolate can leave the system quickly if u require methylfolate you can become depleted in your body if not taking methylfolate as part of the b complex for a week. It's nothing to do with the blood test per say.

[ainslie in reply to waveylines]

oky , thank you for all info

[waveylines in reply to ainslie]

No probs 😊😊

[Calceolaria in reply to ainslie]

Recommendations on here, have been to cease B Complex owing to the biotin content - and supplement instead with vit B 12 separately and Methyl folate separately. Folate will affect blood test results , as I understand it, as levels will drop and result will be lower - that would be the ‘effect’.

I saw a post on here a while back, asking if all supplements should cease before testing and I can understand the reasoning behind that - ie, do we want our results to reflect as to how we are without them, or do we want results to reflect as to how we are with them! Either would show what supplements we might need to adjust but the difference would be we might feel unwell and as an experiment, would it be worth it?

[ainslie in reply to Calceolaria]

might not feel unwell, I dont and I think its important to get to the bottom of it one way or another, opinions do seem to vary

[radd]

ainslie,

The 50 mcg D-biotin in your daily Solgar supplement is a small amount and less than the 1mg that requires stopping before using a thyroid test employing a biotin-streptavidin reaction.

High dose supplements may contain biotin amounts up to 20 mg (2000 mcg) and these require an abstinence for 3 days before the blood draw. Biotin is water soluble so leaves the body quickly.

[helvella in reply to radd]

Agreed.

I think that biotin has become a bit of a panic issue.

It is right that it is mentioned and discussed, but the effect on tests of the types of dose we'd get from a multivitamin or similar will almost invariably be insignificant.

[waveylines in reply to helvella]

In Thornes Basic B complex there is 400mcg of biotin and it definately affected my results.

Ingredients of Thornes Basic B complex

[noquitter]

Blood tests are problematic for a number of reasons, not least that we are all individuals with different optimums. I was (originally) diagnosed by Dr Peatfield, without the use of a blood test, but using morning temperature, achilles reaction, what he could see and what I could tell him and he has been proven right over the years. The TSH blood test is now considered the Holy Grail of thyroid testing, and it falls short. Thyroid disease is complex and nuanced, unfortunately.

[andyjs2 in reply to noquitter]

Hi, what is the achilles reaction you mention? I had never heard of this so am intrigued!

[tattybogle in reply to andyjs2]

this .. reflex relaxation phase is slowed in hypo , speeded up in hyper healthunlocked.com/thyroidu... a-critical-evaluation-of-the-tendonreflex-measurement-as-an-index-of-thyroid-function

[noquitter in reply to andyjs2]

As with a reflex reaction to tapping the knee (ie the knee 'jumps'), the achilles tendon can be tapped (with patient kneeling on a chair with feet in mid-air). If the reflex reaction is slow (the observer needs to know what they're looking at/for) it is an indication of the thyroid being under-active - as it was explained to me at the time by Dr Peatfield. This was one of several tools that were used to make a clinical diagnosis of thyroid problems. Back in the day when doctors knew how to diagnose disease clinically, and not rely on a one-size-fits-all blood test, with 'normal' ranges that were a cobbled together average from a smallish selection of blood tested in one lab, all labs getting a different result.

Hoping that the rumours of individualised medical treatment are true and coming soon!

Hope that makes sense.

[andyjs2]

Thanks for the explanation! So there is no way for me to know what to look for?

[tattybogle in reply to andyjs2]

see the link to the video in my reply to you above , in hypothyroidism the relaxation stage of the reflex reaction is slower than usual ie how long it takes to go back again. but it's not very easy to see / time with naked eye , especially if you've nothing to compare it to .