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Writer's pictureDr. Adrian & Dr. Giulia

Should You supplement with vitamin B12 if hypothyroid?


Vitamin B12 plays a key role in metabolic and cellular processes. B-12 is a catalyst for the production of red blood cells, DNA synthesis, protein conversion, neurological functions, synthesis of fatty acids and nerve health.

B-12 deficiency can occur if you either don't eat enough B-12 or your body doesn't absorb enough B-12. Deficiency symptoms vary depending on the patient and the extent of the deficiency. The most common are:

  • Tiredness

  • Constipation

  • Decreased appetite

  • Tingling in hands and feet

  • Problems with memory

  • Depression

  • Tongue aches


One study found that about 40% (which is a huge number) of patients with hyperthyroidism also suffer from vitamin B12 deficiency.



Hypothyroidism can cause vitamin B12 deficiency. Serum vitamin B12 levels (within reference values) are unfortunately not specific.



The doctor should check:

  1. Serum B12 level: If you have less than 500, it is definitely a positive diagnosis. This is a little more difficult when you have 500 - 1000. If symptoms are present, adding B12 supplements is beneficial.

  2.  Homocysteine should be less than 9

  3. MCV should be less than 92. MCV refers to the volume of red blood cells. If the volume is high, it is a sign that the bone marrow is having difficulty producing red blood cells.


In general, homocysteine and MCV are very useful when we have "normal" serum B12 levels.

The dosage of B12 supplement is 1000-5000 mcg and can be sublingual or intravenous.

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