Just two months ago on January 15th, I wrote an article titled Ten Reasons You May Still Feel Bad. Nearly every hypothyroid patient can have some of those ten problems, and if so, they need to be discovered and corrected.
And one of those issues was low B12. B12 is a vitamin which has a key role in cell metabolism of your entire body, giving you energy, sharpness in your brain, and healthy nervous system functioning.
And unfortunately, a certain percentage of hypothyroid patients have low levels of this important vitamin, largely due to digestive issues common with hypothyroidism– either undiagnosed due to the lousy TSH lab test, or undertreated on T4 meds like Synthroid, Levoxyl, Levothyroxine, Eltroxin, etc.
Symptoms of low B12 can vary from person to person, but can include numbness and tingling in your hands or feet, tremors, poor reflexes, tongue soreness, leg pain, or difficulty walking with balance. Psychologically, you may have memory issues, confusion, or depression. Young women may have difficulty getting pregnant due to low B12.
When doing lab work, you want a result in the upper end of the range. To correct inadequate levels of B12, you’ll want to use high oral B12 (methylcobalamin is the recommended form of B12), B12 cream, or injections by your doctor (especially if you have pernicious anemia) . It’s also recommended to increase your consumption of meat and dairy products, which can be rich in B12.
March 27, 2009 is the kick-off date to begin an awareness campaign of B12 health, with September 23rd being “Vitamin B12 Awareness Day”. And I highly recommend the book Could It Be B12? An Epidemic of Misdiagnoses by Sally Pacholok, R.N. and Jeffrey Stuart, D.O., who are spearheading this awareness.
Have you found yourself with low B12? Tell us your symptoms, how you treated it, and how long it took to stop the symptoms.
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This entry was posted on Wednesday, March 18th, 2009 and is filed under Related conditions due to hypo. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
ibeji said:
Mar 19, 09 at 12:34 amDear Janie,
thanks a lot for your calling attention to this important issue!
However, not only does hypothyroidism frequently lead to digestive issues, but these digestive issues may also make the intestine more vulnerable to potentially harmful foods.
Many people with hypothyroidism develop an increased sensitivity towards gluten (which causes inflammation of the intestine, characterized by bloating and sometimes diarrhea), which further exacerbates the absorption problems of, among other things, vitamin B12.
Furthermore, no mammal is prepared to consume dairy products during adulthood. Dairy products therefore especially harm an already weakened intestine (and it is not only the lactose in the milk which causes the problems, the other ingredients from the milk do as well!).
Many good doctors (the ones who prescribe Armour and also treat weak adrenals, among other things) therefore advise hypothyroid patients to avoid gluten and dairy products (and sweets), since all of these will increase fermentation in and inflammation of the intestine, which causes intestinal atrophy and leads to malabsorption of all nutrients, creating a bunch of additional problems in its wake.
Note that bread made from sprouted grains is an exception to the rule (of avoiding gluten) and can be consumed with moderation (as everything should), since sprouted grains have the same nutritional value as vegetables.
Sara said:
Mar 19, 09 at 6:32 amThere is some great info on pernicious anemia, which is mostly relevant to other forms of B12 deficiency, at the Pernicious Anemia Society website: http://www.pernicious-anaemia-society.org/ We who have pernicious anemia sometimes have as much trouble getting diagnosed and treated as anyone with hypothyroidism! You could be forgiven for thinking that vitamin B12 was a highly controversial experimental drug that cost $10,000 a dose the way some doctors carry on if you want a B12 injection more than once every 12 weeks!
One interesting symptom of B12 deficiency is “the sighs”. “Breathlessness” doesn’t really cover it, it’s more like you feel the need to sigh a lot because you can’t take in enough breath — sometimes it can be mistaken for asthma but there’s not usually wheezing associated with it.
I got diagnosed only because I insisted to my doctor that I wanted more tests than just B12. I read on a thyroid support forum that you should get the B12 carrier protein tested too, which is “Transcobalamin II” or sometimes “holotranscobalamin”. You also need to get a full blood count, folate, and ferritin tested. If you suspect pernicious anemia, get tested for parietal call antibodies and intrinsic factor antibodies. I asked for those and it turned out ny serum B12 was considered “normal” (hah) but my transcobalamin II was quite deficient and I tested positive for antibodies.
To treat, you usually need a “loading dose” of B12 injections, my then doctor actually argued with me that I didn’t need that so I went elsewhere and lucky me found a doctor who agreed that loading doses are a good start. There are various regimens, but usually you get a fair few hydroxycobalamin injections in the first month, then go to one per week or month, depending on what you need. Some people can go a bit longer. If you have pernicious anemia you can only absorb around 1% of all the B12 you eat, but consuming megadoses of 1000-5000mcg can help keep you “topped up” between injections. Sublinguals help some people but I have read that it can be better to take the oral megadoses as they help keep storing B12 in your liver, where sublinguals send B12 straight to your bloodstream.
Anyway I highly recommend checking out the Pernicious Anemia Society site and forums, there is lots to learn.
Mel77 said:
Mar 19, 09 at 3:25 pmThis is very interesting to me. I have had underactive thyroid for a long time, Eutrosig or Oroxine made me very ill for 5 and 1/2 years. In that time I saw 3 Endocrinologists, none of them believed the tablets were making me ill. I found a naturopath and went straight off them. I started with a new endocrinoligist about 18 months later and had the same problem with Eutrosig again. Now I am seeing a new doctor who specialises in nutritional medicine. He has diagnosed me with Hashimoto’s Disease and PCOS (the last endocrinologist told me I wasn’t symptomatic enough to be tested for it!) He has also found that I had virtually no vitamin B or Iron in my blood as well. He has since put me on an iron drip and sublingual vitamin B complex — I love the vitamin B complex, look forward to it every day and a lot of my sweet cravings have subsided. It all seems strange to me how the many endocrinoligists I saw previously did not bother to test for hashimoto’s, PCOS, iron levels and vitamin B!
Mel77 said:
Mar 19, 09 at 3:27 pmAlso forgot to mention that I am now on Dessicated Pig Thyroid or Armour — what a difference, the first time in my life I have not had cold hands/feet!
Victoria said:
Mar 22, 09 at 6:35 pmI had mine tested and it was over range.
My D and ferritin are problems that my doc and I are working on, but plenty of B-12 — must be all the cottage cheese I eat, which I found out is very high in B-12. 
Lisa said:
May 30, 10 at 9:10 amI was dx’d w/hypo when I was sent to a locked psych-ward for suicidal ideations. I was tested for the 1st time and found to have an insanely low THS. Now on synthroid. for about 2 years, still feeling like crap most of the time. I read in a book about hypo re: b-12. I asked my Dr. for a shot and this was DENIED as she patted me on the top of the head and told me I was tired from depression. hmmmm. Went this week to a doctor I was seeing exclusively for a work comp injury,(tho he knows my hypo dx). He gave me a b-12 shot, and I am now really p.o’d. I feel so much better!!!! All those symptoms improving drastically. Haven’t needed my daily hour-long nap since
Now I will look on-line to find reputable outlet for b-12, b/c I am not going back to that needless Suffering! Keep up the good work. I am sending a printout of the info I am finding to send to my “clinic” as they have never heard of such a thing. Paging Dr. Bozo?
Patty B said:
Jul 12, 10 at 1:33 pmI have been treated for hypothyroidism since 1981. In March of 2010 I began to have numbness in my feet and hands, severe leg pain, loss of strength in my legs, and tingling and twitching in my legs. After nerve tests, MRIs, and many blood tests the only abnormality was a low B12 of 190. My neurologist and PCP would not give me injections b/c they said the value was only borderline low. My endocrinologist agreed. I knew my symptoms were caused by a low B12 b/c I no longer ate red meat, had very little dairy in my diet, took large amounts of antacids, and was hypothyroid. I finally found a neurologist who said it was a “no brainer” – my symptoms were caused by low B12 and he started me on injections. It took almost a month before I felt better but now am back at work, no longer depressed, and am feeling much better. I am in physical therapy to regain the strength in my arms and legs. I did a lot of research and knew my own body and would not give up until I found a doctor who understood B12. Don’t give up, keep educating yourself and find a doctor who is educated in B12. He told me that most doctors in the U.S. are a decade behind in understanding what B12 deficiency can do and what a normal B12 value is. Other countries are way ahead of us on this topic. Stay strong – you know your own body best.
sanjay kalamkar said:
Aug 14, 10 at 6:44 amiam also a hypothyroid put on levothyroxine but stll having generalised weakness iam goeing on b12 from today