"At least six neurological and psychiatric papers, in top medical journals, have shown that the normal range should be regarded as at least 500-1,300 pg/ml (rather than 200-1,100), since the cerebrospinal fluid level can be deficient when the serum level drops below 500, and neuropsychiatric symptoms often occur at serum levels between 200 and 500 pg/ml (VanTiggelen et al, Lindenbaum et al, Mitsuyama/Kogoh, Nijst et al, Ikeda et al, Regland)."
In Japan and Europe, vitamin B12 serum reference ranges start at 500 or 550pg/mL. You really need to get B12 levels up ASAP. You may find some of your symptoms vanish. My sister had an 8cm ovarian cyst and i had a 25cm ovarian cyst. We both have juvenile autoimmune pernicious anaemia. Was it due to malabsorption of B12? It is a strong suspect so i had a look online about this and found quite a few articles...
"Methionine promotes the excretion of estrogen.
Are you eating any eggs, lentils, yogurt, seeds?
Methionine - is an essential amino acid that cannot be synthesized in the body. Methionine is a precursor for the other sulfur amino acids, cystine, taurine, and glutathione. It has the ability to be a methyl donor to other molecules, which is essential in formulating RNA and DNA. Methionine is necessary for the absorption, transportation, and bioavailability of selenium. In order to be properly utilized, methionine requires the help of its cofactors -- Vitamins B6, B12, choline, folic acid, and magnesium." Heal Thyself - Estrogen dominance
"Methylation involves conjugating methyl groups to toxins. Most of the methyl groups used for detoxification come from S-adenosylmethionine (SAM). SAM is synthesized from the amino acid methionine, a process which requires the nutrients choline, the active form of B12 --methyl cobalamin, and the active form of folic acid --5-methyltetrahydrofolate. SAM is able to inactivate estrogens (through methylation), supporting the use of methionine in conditions of estrogen excess, such as PMS." Tuberose - Liver Detoxification
Hypothyroidism is another cause of ovarian cysts just to add which is another suspect. I aimed for a TSH of 1mU/L to start with as my sister has more energy then anyone i know and her TSH is 0.9mU/L. I have issues at a cellular level as well as Hashimoto's thyroiditis but my first step was a TSH of 1mU/L.
I forgot to add the source for vitamin B12 reference ranges: John Dommisse MD - Vitamin B12 Deficiency - Symptoms, Signs & Optimal Treatment.
Just wanted to also add this info:
"When progesterone is not abundant enough to offset this role, over growth will occur forming fibroids, cysts and endometriosis. Under estrogen's dominance, too many follicles are produced by the ovary, and those that don't mature to ovulation are pushed to the side of the ovary and continue to grow. This produces ovarian cysts and PCOS (Polycystic Ovarian Syndrome).
Although the cause of endometriosis is not known, we do know that Estrogen Dominance is always present and when the Estrogen Dominance is taken care of, the endometriosis is halted. Endometriosis is one of the main reasons for hysterectomies, and is fixable by balancing the hormones." Natural Body In Balance - Cysts, Fibroids and Endometriosis
Okay i'll stop spamming now LOL
Geez i forgot the first section of the article...
"Fibroids, ovarian cysts, PCOS, and endometriosis are all Estrogen Dominance symptoms. Estrogen's main role is the proliferation of cells."
Okay now i'm done. :P
As a rule of thumb, until we each find where we feel best, many find that FT4 has to be about midrange and FT3 upper half of range before symptoms are relieved. However, that's a rule meant to be broken once we find where we each feel well.
If you are asymptomatic where you are, there's no reason to push it. My labs are not as high as yours, and I've been asymptomatic for years. I also started feeling hyper with my labs still very much within range. One hypo can be hypo and one hyper with the exact same labs. It's all about how you feel...
Even though it's in range, your vitamin B12 is too low. Low levels of vitamin B12 can cause neuropathy. If you bring your levels up, some of the pain may go away.
I have pernicious anemia that was untreated for many years and as a consequence, I have some permanent nerve damage, since B12 deficiency affects the nerve endings.
What's your stomach issue? Hypothyroidism also causes GERD/acid reflux. I spent years on Aciphex for GERD and since my thyroid levels are in check, I rarely have any type of stomach issue.