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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does B Red Cell Folate(1564)nmol/L & TSh (.49) & Low Vitamin Suggest?

I have Graves disease and have just had my blood work done after feeling like it was on the rise.
I cannot get onto my specialist and my B red cell folate is 1564 nmol/L and my ultra sensitive TSH is .49mU/L , vitiman D is down too. What does this mean?
Mon, 6 Jul 2015
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Endocrinologist 's  Response
Hyperthyroidism can be commented only if you have a simultaneous t3 and t4 values. You should be on a non specific beta blockers if you still have symptoms of hyperthyroidism like tremor, palpitation, heat intolerance and loose stools. Red cell folate level is normal. Vitamin d. Deficiency needs to be corrected for which you can take 50000 units of vitamin d weekly for 8 weeks and 2000 iu daily thereafter for maintenance. If t3 and t4 are high, you will have to increase the dose of anti thyroid medications as the TSH value can be deceptive in cases where you hav missed anti thyroid medications for few days or if you hav some heterophile antibodies having a spuriously normal or even high TSH.
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What Does B Red Cell Folate(1564)nmol/L & TSh (.49) & Low Vitamin Suggest?

Hyperthyroidism can be commented only if you have a simultaneous t3 and t4 values. You should be on a non specific beta blockers if you still have symptoms of hyperthyroidism like tremor, palpitation, heat intolerance and loose stools. Red cell folate level is normal. Vitamin d. Deficiency needs to be corrected for which you can take 50000 units of vitamin d weekly for 8 weeks and 2000 iu daily thereafter for maintenance. If t3 and t4 are high, you will have to increase the dose of anti thyroid medications as the TSH value can be deceptive in cases where you hav missed anti thyroid medications for few days or if you hav some heterophile antibodies having a spuriously normal or even high TSH.