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Many patients are "treated" with levothyroxine but not optimized, meaning their TSH is within the reference range but not in the lower portion where many Hashimoto's patients feel and function best

It seems that the efficacy of B9 supplementation is dose-dependent such that, the combination of 1 mg/d folic acid, 25 mg/d vitamin B6, and 400 g/d B12 during 6 months did not have any significant effect on serum homocysteine and symptoms of migraine (74)

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This challenges the assumption that more potent always means harder to tolerate

Baseline characteristics are shown in Table 1

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