I forgot to say with levels that low you need to find out the cause of why your B12 is so deficient. My reason - autoimmune pernicious anaemia. B12 awareness lists causes of B12 deficiency...
"What Are The Causes Of B12 Deficiency?
Decreased stomach acid
Atrophic gastritis
Autoimmune pernicious anemia
Helicobacter pylori
Gastrectomy, intestinal resection
Gastric bypass surgery
Malabsorption syndromes
Crohn’s disease
Celiac disease (gluten enteropathy)
Chronic pancreatitis
Bacterial overgrowth (small bowel)
Fish tapeworm
Alcoholism
Malnutrition—Eating disorders
Vegetarianism
Advanced liver disease
Transcobalamin II deficiency
Inborn errors of B12 metabolism
Certain drugs
Nitrous oxide"
You have vitamin D and vitamin B12 deficiency. Your lab reference ranges are too low for both vitamin D and vitamin B12. TSH range too high.
I posted info below on where you need to be for good health Vitamin B12 testing is either in ng/L (pg/mL) or pmol/L.
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"The Vitamin D Council recommends maintaining serum levels of 50 ng/ml (equivalent to 125 nmol/L*), with the following reference ranges: Deficient: 0-40 ng/ml (0-100 nmol/l) Sufficient: 40-80 ng/ml (100-200 nmol/l) High Normal: 80-100 ng/ml (200-250 nmol/l)"*
*Vitamin D Council.
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"...it is well-established in the scientific literature that people with B12 levels between 200 pg/mL and 350 pg/mL – levels considered “normal” in the U.S. – have clear B12 deficiency symptoms. Experts who specialize in the diagnosis and treatment of B12 deficiency, like Sally Pacholok R.N. and Jeffery Stewart D.O., suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL. They also recommend treating patients with normal B12, but elevated urinary methylmalonic acid (MMA), homocysteine and/or holotranscobalamin (other markers of B12 deficiency).
In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL, the level associated with psychological and behavioral manifestations such as cognitive decline, dementia and memory loss."*
*Chris Kresser - B12 deficiency: a silent epidemic with serious consequences
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Thyroid Tests "Normal" But You Don't Feel Well?
If you're undiagnosed, or a thyroid patient taking thyroid hormone replacement medications, being in the "normal" range does not mean you feel well, or that your treatment is optimized. What levels are considered "optimal*" by many integrative physicians?
~ TSH - Typically less than 2.0
~ Free T4 - Top half of the reference range
~ Free T3 - Top half - top 25th percentile of reference range
~ Reverse T3 - Lower end of normal range
~ Thyroid Peroxidase Antibodies (TPO) - Within reference range
~ Vitamin D - Above 50
~ Ferritin - Above 60 (Above 80 if experiencing hair loss)
* we are all different, one size doesn't fit all, so these are guidelines. Your optimal levels may vary."*
*Hypothyroid Mom - Top 5 Reasons Doctors Fail To Diagnose Hypothyroidism