Low vit B12, D, iron? Blood test results - help please! (Pic)

[Rosie70]

I've been feeling a bit rubbish for about a year, I'm mid 40s. Main issue is hair loss. I also have a pounding heart especially when I walk upstairs, skin prick feelings on and off; and low mood. Had blood tests done and called the docs for results. Told they were all normal, no further action needed. So I asked the surgery to print them out - see pic attached.

It looks to me as though I'm at the low/very low end of 'normal' on certain ones - particularly vitamin D - 50 nmol; vitamin B12 - 269ng/L; serum ferritin -19 ug/L; serum folate - 3.3 ug/L. Serum TSH level which I think is thyroid is 2.4. Should I be taking supplements with these results? If so, does anyone know how much and what I should be taking? I'd be very grateful for your thoughts. Thanks!

Ferritin is very low and D, folate and B12 are pretty low too. Your thyroid TSH is over 2 so you should check your FT4 too and, if it's bottom of range, it needs further evaluation. I can't see the print out, but with a TSH of 2.4 your thyroid could be struggling. Take a look at thyroid uk website.

Thanks BeBrave. Does the low ferritin signify anaemia? Are all these things linked?

Yes you are borderline - take supplements from pharmacy. My vitamin d was 30 and I was told to take 1000 unit tablets twice a day.

Ferritin is stored iron so its important to be +70. It would be good to know why it's low. Mine was 10, due to heavy periods and undiagnosed Hashimotos thyroid disease. I had to take 3x210mg ferrous fumerate a day for 3 months.
Low vit D, B12, folate and ferritin are iften linked with autoimune conditions such as pernacious anaemia and Hashimotos (causing hypothyroidism). I only know from my experience but borderline results can get overlooked until you get worse. Your folate seems really low (under range?) and folate and B12 work together.

Thanks Bebrave. Do you think I should go back to the GP?

Did the supplements work for you?

I think your GP should respond to your symtoms and i definately think you should have your FT4 checked.
The supplements and thyroid medication worked for me. I'd reached a point that i couldn't exercise and was feeling sleepy at work.
I took a private test though that showed i don't convert ft4 to ft3 (thyroid issues can be complicated!) so, luckily for me, I'm on ft3 and ft4 medication. I take supplements to keeps my levels optimum now.

Btw, low B12 can cause numbness, pins and and needles. Pernacious anemia can be the cause but other things like coeliac can cause malabsorption. GP is best placed to advise.

TSH is thyroid stimulating hormone and is in the " normal" range but they only tested about 12 students 40 years ago to get an average....

Many people don't function well with a TSH over 2 and it would explain hair loss

All the things you mention are also symptoms of the menopause/peri menopause. I had test after test for my weird symptoms (which included heart palpitations, anxiety, fatigue, tingling skin, massive hair loss). I had MRIs, brain scans, the lot. Was petrified. Turned out it was all due to estrogen deficiency. GP had never considered this, due to my age (39 at the time) and absence of hot flushes (!) My Vit D and B12 were also low, but this wasn't the cause of my symptoms.

Have a look at www.34-menopause-symptoms.com/perimenopause.htm

Thanks for suggestions. I've read some threads on here and decided to self treat for now with 1000 B12 sublingual plus 4000 vit D and Floradix. Would this be enough to help raise the ferritin and folate? I think I read somewhere that you shouldn't supplement with folic acid in case it masks something?

Oh I'm not sure about that - I was given folate for my folic acid defincency too. But I clearly had a reason for being low - pregnancy, breastfeeding etc.

On my print out from gp on ferritin it clearly said 50 was borderline, 70 - 200 (I forget the higher number exactly) was good.

When you look up ferritin reference ranges in the uk this is the case. I did and do notice a difference with a ferritin over 70. I achieved that through cutting out milk for a month and eating lots of food rich in iron, and taking vit c (just normal milk and yoghurt), after having issues with iron tablets.

Yes the thyroid is a bit up but annoyingly in 'range'. It's worth asking for this to be monitored. Any history of thyroid in family?

What was your thyroid result and did they test Ft4 as well as TSH. That's the minimum needed to test thyroid function and better still is if they test antibodies for Hashimotos. If your TSH was over 2.5, it needs monitoring and if Hashimotos thyroiditis runs in the family, you really need your antibodies checked.

They didn't test the Ft4. Nobody in the family has Hashimotos though. Does anyone know whether the deficiencies in B12, D and iron etc can cause problems with thyroid? Or vice versa? If I boosted the vitamins could this reduce the thyroid levels? Thanks

They can certainly cause similar symptoms. As to if they'd change the tsh result if better I'm not sure. I've read in places 'on the internet' (aka not very trustworthy) they can, but never seen an actual scientific paper showing this. If it did, I expect gps would get those right to see if it impacted.

I have read a paper that says if thyroid patients aren't fully well with thyroxine, to first rule out all the other typical issues such as vit d, b12 and ferritin, I suppose the aim being that if they're really good it can't be that, before going down the route of looking at conversion issues. (T4 to t3, adding t3 in). I think this has been possibly twisted round to say if good they fix your thyroid but I don't think that's the right correlation. If good they may fix your symptoms. And i myself found that as did a friend.

Rose, vit d is thought to have an effect on thyroid in Canada but in the UK nice say it doesn't

Thanks Ekphrasis. Did you improve your vitamin status which in turn improved your symptoms but not your thyroid levels? Interesting re Canada thanks Ivy.

That is interesting ivy. I'm very happy to be corrected but I've not found any papers that show direct correlation. E.g. "Vit d goes up, tsh goes down, t3 goes up."

I try to keep my thyroxine just below 1. What I was doing was keeping it around 0.3 on advice from endo and gp - however I do actually think I was slightly over replaced but still having symptoms of tiredness and aching muscles. I was struggling to put on weight (common for me even when underactive). When ferritin went up and vit d etc, I found getting my tsh a tad higher at just below 1 was actually better. Ive regained a lot of strength and energy. I've also started taking ubiquinol (for ttc) which has really helped.

That comes across that I don't believe you ivy! I'd love to know more about that impact of vit d.

I didn't say taking vit d makes tsh go up or t3 go down or which ever way round you said.

Vit d is though to have an effect on the body with autoimmune disease and therefore will be of help if vit d are at optimum levels with thyroid problems.

But this is in Canada - not in the UK

As for you having tierd and aching muscles, those are symptoms if hyperthyroidism

Ok thanks for clarifying ivy - I speak from the POV of no functioning thyroid at all. Auto immune issues are notoriously difficult to control or manage.

Yes it was hyper symptoms at 0.3 tsh despite t4 being in range. But I didn't feel well at around 1 as the vit d and ferritin were the issue, without me knowing and only corrected through me doing a lot of pushing to get tested

I was interested in this and found two studies. There is a link to low vit d and the auto immune thyroid response. And a greater response to the antibodies leading to hyperthyroidism.

http://www.wellnessresources.com/health/articles/lowvitaminndcontributesstothyroidd_problems/

It was quite in this study, which has an interesting discussion near the end.

www.ncbi.nlm.nih.gov/pmc/articles/PMC3921055/

Link fail

http://www.wellnessresources.com/health/articles/lowvitaminndcontributesstothyroidd_problems/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921055/