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Free T4 and Vitamin B12 levels plunge - This is weird

Hello. I am a 44-year-old male, and I have autoimmune hypothyroidism.

In June 2017, my situation was the following:

I had been taking Synthroid 125 (5 times per week) and Synthroid 137 (2 times per week), for about 2.5 years. I had been taking methylcobalamin Vitamin B12 (4000 mcg per week), for about 1.5 years. I had not taken any Vitamin D supplements for 5 years. I had never taken any Selenium or Vitamin E supplements.

In June 2017, I had some blood tests, and these were the results:

FT4 = 1.53 (normal range = 0.82 - 1.77)

FT3 = 3.3 (normal range = 2.0 - 4.4)

TSH = 0.084 (normal range = 0.450 - 4.500)

Vitamin D, 25-Hydroxy = 24.4 (normal range = 30 - 100)

Vitamin B12 = 873 (normal range = 211 - 946)

Folate (Folic Acid) (serum) = 13.3 (normal range = >3.0)

Vitamin E (Alpha Tocopherol) (serum) = 7.9 (normal range = 5.3 - 17.5)

Selenium (serum/plasma) = 136 (normal range = 79 - 326)

After the June 2017 blood tests, I lowered my Vitamin B12 dosage. I started alternating between 4000 mcg per week and 3000 mcg per week. In other words, one week, I would take 4000 mcg. The next week, I would take 3000 mcg. Everything else (Synthroid, Vitamin D, Vitamin E, and Selenium) stayed the same.

In December 2017, I had some blood tests, and these were the results:

FT4 = 1.42 (normal range = 0.82 - 1.77)

FT3 = 2.9 (normal range = 2.0 - 4.4)

TSH = 0.106 (normal range = 0.450 - 4.500)

Vitamin D, 25-Hydroxy = 19.0 (normal range = 30 - 100)

Vitamin B12 = 878 (normal range = 232 - 1245)

After the December 2017 blood tests, everything (Synthroid, Vitamin B12, Vitamin D, Vitamin E, and Selenium) stayed the same.

In late October 2018, I had some blood tests, and these were the results:

FT4 = 1.00 (normal range = 0.82 - 1.77)

FT3 = 3.0 (normal range = 2.0 - 4.4)

TSH = 3.010 (normal range = 0.450 - 4.500)

Vitamin D, 25-Hydroxy = 17.0 (normal range = 30 - 100)

Vitamin B12 = 304 (normal range = 232 - 1245)

Vitamin E (Alpha Tocopherol) = 7.2 (normal range = 7.0 - 25.1)

Vitamin E (Gamma Tocopherol) = 0.6 (normal range = 0.5 - 5.5)

Selenium (serum/plasma) = 174 (normal range = 91 - 198)

As you can see, the FT4 has plunged from the June 2017 and December 2017 values. The Vitamin B12 also has plunged from the June 2017 and December 2017 values. The FT3 went down from June 2017 to December 2017, but went up from December 2017 to late October 2018.

As for hypothyroidism symptoms, lately I have had excessive constipation. Also, I feel cold and pain in my lower back. And I have a wound on my leg that, in my view, is taking too long to fully heal.

In July 2018, I had CMP, CBC, and cholesterol blood tests. Everything was normal, except the following:

Platelet Count = 111 (normal range = 150 - 400)

Mono% = 12.4 (normal range = 4 - 12)

BUN = 22 (normal range = 6 - 20)

But I've had these abnormal values for years. These values are nothing new.

Because I was feeling pain in my groin area, I had a urinalysis in August 2018 and an ultrasound of my scrotum in September 2018. The urinalysis showed presence of uric acid and calcium oxalate, a squamous epi level of 5, a pH of 5.0 (normal range = 5.0 - 8.0), and a specific gravity of 1.031 (normal range = 1.005 - 1.030). I thought that the urinalysis showed kidney stones, but the primary doctor said that I was just dehydrated.

The ultrasound showed a small varicocele on one of my testicles. Varicoceles are similar to varicose veins in the leg.

There has been a significant change in my diet in the last few months. I've been eating shrimp from time to time. I noticed that the shrimp contains calcium (60 mg, 6%), and I know that calcium interferes with thyroid hormone.

So, given all of the above information, what is causing my FT4 and Vitamin B12 levels to plunge? My endo and I will be meeting soon, but she has already said that she thinks that my TSH, FT4, FT3, and B12 levels are great. So, she is clearly basing her opinion only on the normal range.

Thanks for any info.

2 Responses
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1756321 tn?1547095325
You have vitamin D deficiency for years and did not address this? O_o Vitamin D is essential to absorb and use calcium.

Interesting with the B12 serum.  
After suffering B12 malabsorption symptoms for decades I know B12 serum is not accurate.  From B12.org...

"At present, the best and most reliable tests for a vitamin B12 deficiency are the holoTC test, which uses holotranscobalamin, and the MMA urine test, which uses methylmalonic acid."
Helpful - 0
In the past, whenever I took Vitamin D supplements, my FT4 and FT3 levels went down, and I felt bad. Thus, I do not take these supplements.

As for B12, I think that the website you're talking about is www.b12d.org, not www.b12.org. I see that www.walkinlab.com is offering the MMA urine test for $99. However, I have not seen any provider of private tests that offers the holoTC test. Is the holoTC test something that's usually ordered by a doctor?
The info I mentioned is on b12-vitamin (dot) com but strangely has B12 org written at the top of the article lol. You could Google: "Dr Schweikart B12" to find the website.

I live in Australia so all tests have to be requested by a doctor.  I found one of the pathology labs in Australia state this:

"HoloTC has better sensitivity and specificity for assessing B12 status
(not affected by haptocorrin levels)

- It’s not used as a first line test yet
- Limited availability and high cost"

I found Life Extension B12 panel costs $68.25 (retail price $91)

This panel contains the following tests:

Vitamin B12
Urinary Methylmalonic Acid

Not sure what is going on with your vitamin D supplements. Hmmm. Try getting some sun to boost vitamin D. My BOM weather app UV forecast for tomorrow states I need sun protection from 7:50 am to 3:30 pm. UV index predicted to reach 12 [extreme].
Is it possible that my body's "intrinsic factor" is under attack? Is it possible that my body has anti-"intrinsic factor" antibodies? There is a blood test for these antibodies. Maybe my endo will order that test.
I have positive intrinsic factor antibodies and positive parietal cell antibodies. As you have Hashimoto's thyroiditis you are at risk of other autoimmune diseases including pernicious anaemia. Check out the article from outsmartdisease - List of diseases associated with Hashimoto's thyroiditis.
I have not had any vaccines since summer 2009. However, for the last 30 years, I have been getting allergy injections (allergy immunotherapy). These injections contain things to which I'm allergic (ragweed, pollen, cat dander, etc.), and these injections presumably cause my body to produce antibodies to these allergens. Is it possible that something in the allergy injections that I have received in the past year, has caused my immune system to attack my intrinsic factor and/or my parietal cells?
A few excerpts from Allergen Immunotherapy - Journal of Allergy and Clinical Immunology...

"Possible mechanisms of immunotherapy:

*Reduction in specific IgE levels (long-term)
*Induction of IgG (blocking) antibodies
*Reduced recruitment of effector cells
*Altered T-cell cytokine balance (shift to TH1 from TH2)
*T-cell anergy
*Induction of regulatory T cells

"... there is some concern about the use of immuno-modulatory treatments in patients with autoimmune disorders,
immunodeficiency syndromes, or malignant disease.

Although there is no hard evidence that SIT [specific immunotherapy] is actually harmful to these patients, some clinicians feel uncomfortable about manipulating the immune system in such patients, not least because of the risk that spontaneous and unrelated variations in the autoimmune disorder or cancer might be blamed on SIT.

However, provided
the risks and benefits are weighed and discussed with the patient,
SIT can be administered where the risk/benefit ratio is considered
to be in favor of treatment."
I spoke to my allergy doctor about allergy injections and the above-mentioned "Induction of IgG (blocking) antibodies ". The doctor said that the blocking antibodies that result from the allergy injections, are antibodies that block allergic reactions. According to the doctor, these antibodies do NOT block intrinsic factor or the parietal cells that produce intrinsic factor.

The doctor said that, if allergy shots had the side effect of producing antibodies that block important things like intrinsic factor and parietal cells, then allergy doctors would be out of business. That explanation did not provide me with any comfort. After all, vaccines have been causing problems, and somehow, vaccine manufacturers have not gone out of business.
Avatar universal
Re your low FT4 and high TSH - after you take your Synthroid in the morning, are you remembering to wait 1/2 to 1 hour before eating or drinking anything??? You must do this to ensure good absorption of the Synthroid. I made myself hypo by forgetting this - I was taking the pills and eating breakfast right away. And drinking calcium fortified orange juice which really interferes with absorption.
Helpful - 0
Yes, I do wait at least an hour before eating. Most of the time, I wait more than an hour. And I don't drink anything but water, anyway.

As I mentioned, I was eating shrimp that contains calcium. But I was eating that shrimp for dinner, not in the morning. But I will stop eating that shrimp for the time being.
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