My TSH is 4.8 microIU/ml and T4 and T3 is normal. And Vit B12 is 196 pg/mL and vit D level is 5.9 Do I need Further more investigations. What is the reason for these low levels and what should be my treatment line.

Dr. Amar DeepHomeopath9yrs exp

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Thank you for writing to us. Please note the following in respect to your queries: vitamin b12 deficiency can happen if you have certain conditions, such as: atrophic gastritis pernicious anemia conditions affecting the small intestine, such as crohn's disease, celiac disease, bacterial growth, or a parasite heavy drinking immune system disorders, such as graves' disease or lupus long-term use of acid-reducing drugs. You can also get vitamin b12 deficiency if you're a vegan (meaning you don't eat any animal products, including meat, milk, cheese, and eggs). Treatment for vitamin b12 deficiency: if you have pernicious anemia or a problem with its absorption, you'll need to replace vitamin b12 by injection initially and then continued injections, high doses of an oral replacement, or nasal therapy for life. If the issue is that you don't eat animal products, you can change your diet to include vitamin b12-fortified grains, a supplement or b12 injections, or a high-dose oral vitamin b12 if you are deficient. Causes of vitamin d deficiency: vitamin d deficiency can occur for a number of reasons: you don't consume the recommended levels of the vitamin over time. Your exposure to sunlight is limited. You have dark skin. Your kidneys cannot convert vitamin d to its active form. Your digestive tract cannot adequately absorb vitamin d. You are obese. Treatment for vitamin d deficiency treatment for vitamin d deficiency involves getting more vitamin d -- through diet and supplements. If you don't spend much time in the sun or always are careful to cover your skin (sunscreen inhibits vitamin d production), you should speak to your doctor about taking a vitamin d supplement, particularly if you have risk factors for vitamin d deficiency. If you still need any help get back to me. Thanks.graves diseasevitamin b1 deficiency 

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