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I have recently been treated for hypothyroidism after years of symptoms doctors missed, including extreme fatigue. After thyroid hormone treatment, much of my anxiety dissipated, but the fatigue remains. So, I revisited my medical records and saw that a recent [B]FERRITIN value was 18[/B], and [B]SERUM B12 was 267[/B]. My grandmother, father and sister both have been diagnosed as b12 deficient, but my level is apparently not low enough. I asked my Dr. about the b12 and esp the ferritin and was told specifically NOT to supplement with iron.

I have read some medical literature on b12 and ferritin, but am somewhat confused because of the differing opinions on minimum values. I understand that from a strictly clinical standpoint, my levels are not considered anemic, however, I am looking to find what ferritin and b12 levels have been found to be optimum from people who have actually experienced anemia and recovered from it or low ferrtin, B12.

I have read that I should aim for 30-50 ferritin, and over 400 b12, but since there is no consensus, I am seeking opinions here.

Any suggestions welcome!
Those are the values I've read as well.

Your value is a low B12 number. I'd suggest getting the B-12 shots until the numbers come up, but if you can't get your dr to do the shots, there is also sublingual B12.

My B-12 numbers were in the low 200's a few months ago, and I thought I had a serious illness. Numbness, tingling, serious symptoms.

After twice monthly B12 shots and sublingual B-12 vitamins, my levels came up, but I still have to stay on top of it. I've read that it's very hard to replenish your B12 supply and keep it there. Everything in your body needs B12 to function.

Ask about the shots and get the sublinguals at the least. You'll feel much better.

Take care.
Thanks for your story. From reading around here since I asked my question, I came to see that my serum b12 can be considered low. Unfortunately, drs I have seen, including a hematologist, strictly follow the current lab value wisdom and saw no problem. I have asked on a number of occasions to different drs for a b12 shot, but was told that unless I an "diagnosed" with anemia it is not useful. Incidentally, the hematologist suggested I seek out alternative medicine for "chronic fatigue".

I did start on a sublingual regimin a few weeks ago, but have yet to feel a big difference, but I expect it may take a while.

I am wondering, since you have received b12 shots and are supplementing, what end b12 value, if any, your dr has in mind. I am trying to learn what a "good" b12 value is by asking advice from anemic and deficient people who have actually [I]experienced[/I] fatigue.

Interesting on the B-12. Back when I first found out about my mild anemia, my B-12 was measured at 310 which my doctor said was "good." We didn't do iron tests until much later and I know my ferritin is at 5 (this was after I used Spatone iron and got the hematocrit and hemoglobin back in the normal range).

Technically, I guess I am hypthyroid as I had my gland removed due to thyroid cancer. I am fully medicated though and my thyroid numbers are good so I don't know if this really is the culprit.
I read on a pernicious anemia site that they like to shoot for having serum levels of 800-1000.
I am also hypothyroid, and I was also wondering what the correct levels of thyroid should be to feel better. I know that one affects the other, re iron and thyroid, but I'm not sure which is which. I had my thyroid burned out with radioactive iodine about ten years ago, and have been having problems on and off with the hypothyroid. I read on the thyroid board that the TSH should be 1.0. Mine rose to 11.8 recently, which may be why I'm feeling so bad. My B12 is normal at 512, I guess. But I'm still trying to deal with the iron as well, and get a ferritin level so I can work with that.
Hi Fjones:

I would be glad to let you know what I have learned. Seems as though we have similar situations (but from what I understand, not that uncommon).

I was doing my usual web search trying to educate myself on possible reasons my thyroid treatment has thus far not been successful, esp with regard to iron status. I did find a few articles - though only the synopses, that did mention that low iron (ferritin value) affected thyroid status....It has something to do with thyroid hormone synthesis and can affect thyroid metabolism (reduce t4 to t3 conversion). As I understand it, t4 is converted to t3 in the liver.

I have posted elsewhere on this board, since I first asked this question a few months ago, and after reading some medical articles and posts here, I have come to the conclusion that 70 ferritin might be a good level to achieve for me. There is a wide array of opinion on the matter of optimum ferritin, however.

If you have further questions about thyroid levels, ferritin or b12, and my own labs, etc., just let me know :)

PS You included your b12 level, but not your ferritin. I was unsure whether you were just low iron, iron deficient, or anemic. For thyroid commentary, it would be good to know your free T4 and free t3 levels if you have them.
Ooops forgot to answer you thyroid optimum question. I have learned that good clinicians aim for a TSH around 1. It all depends, however, on the free t4 and t3 levels if they are in the just a bit above mid normal range. Of course, all that is really important is how you feel, even if the labs differ....

Right now, I have a TSH of .48 (.27-4.2)
Free T4 of 1.42 (.8-1.70)
Free T3 of 2.84 (1.80-4.20)

My free t4 is optimum (or maybe a bit high even), but my free t3 is not optimum. And, I still feel poorly. I would like to see how I feel with a higher FT3. I am currently at 88mcg. I tried 100, but felt bad in a different way, probably too much T4.

There are a few reasons for the lower t3: iron deficiency, the lexapro I still take, or just a mystery reason I have not figured out yet. I may ask for a t3 supplement to augment my treatment when I do next to the dr. For the moment, I am working on getting the ferritin up and cutting back on the lexapro. I read that SSRIs can decrease T3. [Long story - got put on psych meds for depression and anxiety before the hypo was discovered]

I am also working on the fatigue...iron, and of course, b12. I tried supplementing with b12, but think shots would have more success. So, I am trying to find a dr who is sympathetic to a trial of IM shots.

OK hope that covers it for the moment. :wave:
Hi. Thanks for all the information. My last ferritin was 11 according to the last hematologist I saw. He never did show me any lab results on paper. This was before April 9, when I had the 2 hr. infusion of Infed. This doctor never did a ferritin test since, or any other iron levels. I felt okay for a couple of weeks, then I started going downhill pretty fast. I have been to the ER twice in the past week. I thought the sypmtoms were iron related, extreme dizziness, fatigue, brain fog. But also I've had really bad balance issues for the past few days and almost collapsed completely. Those I think are thyroid related. According to the last blood test I had, CBC, my hemaglobin is down to 11.6, and my RBC is down to 3.86. Those levels shouldn't be causing my discomfort, according to my doctors. But they did test my thyroid and my TSH was 11.8, which I now know is pretty high. My T3 was 8.2 back in January, and T4 was 40 back then, also high. The ER doctor started me off with a prescription of Synthroid, .075 mgs. I hope to get the TSH down to 1, so I could rule the thyroid issue out if I don't feel better at that level. I've read several places where 1.0 is the level people feel better. But I'm still waiting for my ferritin results from my last doctor.
Some questions come to mind. You say your ferritin is 11 and you had an infusion on April 9. Were you diagnosed with anemia at that time or just deficiency?

I wondered if the dr has determined the cause of your anemia? He should tell you....

Ok. Now I see your latest CBC had a hemoglobin of 11.6. Anything below 12 is definately anemia. I don't know how your drs can discern among symtoms - a lot of hypo and anemia symotoms are similar and one exacerbates the other. I think that is a bit of a fib when they tell you that your low hemoglobin (anemic condition) is not "causing your discomfort"

[QUOTE=fjones1;2995122] But they did test my thyroid and my TSH was 11.8, which I now know is pretty high. My T3 was 8.2 back in January, and T4 was 40 back then, also high. [/QUOTE]

I don't understand these thyroid values. Are you saying your T4 (total) was 40 in a typical range 4.5-12? At any rate, the total tests are not direct enough and measure total amount of T4 present in the blood - the protein bound (unavailable) T4 and the Free T4. You need to have Free T4 and free T3 measured to give a better picture of your situation.

Sometimes a total T4 can be high and mistakenly indicate hyperthyroidism, when in fact, a great majority of the T4 hormone is bound and unavailable...

Sparkles- I was doing some research and found this thread . I see that you have been looking at the ferritin issue for a few months. Have you had any luck in pulling up your ferritin level?

You have responded to me on another thread regarding some research. I am hypo(hashis) and have low ferritin. A month into taking the slow fe my tsh jumped up. I really want to get the ferritin in good order so the iron supplementation is not affecting the tsh and levo med. So, I am looking to find people who successfully raised their ferritin and find out how they did it.
Thanks for your help!
Hi there. Just read your post today from March when you first started your B12 injections. Are you feeling alot better now? Did the numbness and tingling go away yet? How often did you get your injections? Did you supplement with sublingual B12? I'm very interested in the B12 deficiency possiblity. Have had tingling/numbness and vibrating since March 2006. Could you please tell me your circumstances?
thank you so much
oops, that posting from me was with regards to JAPLOPPER'S posting (but any input is greatly appreciated).

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