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vitamin b complex and b12

Hi i'm new to this and still feel like I have a lot to learn .I always think of these questions after i have attended my rheumtology appointments and don't always want to call the help line and take up their time for people in most need.

Why do we take folic acid? and only once a week 3 days after methotrexate? i can recall my consultant telling me folic acid too is a vitamin B ,I started taking vitamin b complex and vitamin b12 from Holland Barratt(the supermarket ones don't appear to work for me)I checked with the consultant if it was ok to take whilst on methotrexate and he confirmed it was ok .

The reason i started was because i felt that this took away a lot of the fatigued or spaced out feeling i was getting and still this works well for me .Just over thinking what was said during my visit now .If i can only take folic acid on the third day (which is a Vitamin b)

but then how come the consultant didn't say i couldn't take my own purchased B complex and B12 all the time (6 tablets a day indicated on the holland barratt bottle) on the day i take methotrexate?

Is folic acid not the same as the vitamin b complex and b12 vitamins?

6 Replies

Hi Lorraine,

Methotrexate is a folic acid depleter and that is why you have to take folic acid supplements. I have put a link to our article on methotrexate for you to read where it talks about this:


Folic acid is one of the B vitamins and is often referred to as vitamin B9. There are a number of differrent chemicals referred to as B vtamins. I have put a link to the section on the NHS website about B vitamins:


It is worth looking at the strength of the various B vitamins in the supplements that you have and double checking with your rheumatology team that this is OK. Alternatively you can ask the pharmacist at your local chemist.

Hope this helps Lorraine,


Beverley (NRAS Helpline)


Welcome Lorraine. It may help you to do as I do leading up to an appointment, make a bullet point list of any questions or symptoms that would make sense to your Rheumy if he wishes to look at it. I find that way usually all my questions are answered & symptoms addressed.

Re your folic acid question, as MTX is immunosuppressant that inhibits the metabolism of folic acid this means that it depletes the little folate our body stores & why we're prescribed folic acid, to replenish what is lost. As we need folic acid as part of the production of immune system cells it's important that we don't become folate deficient. Much of this will be seen in your regular drug monitoring blood test so I wouldn't be too concerned about taking extra supplements. If your Rheumy feels it necessary he can advise you take more of your prescribed folic acid. We often discuss how much we're directed to take, for example when I first started on MTX 6 years ago I only took 5mg the day after MTX, that was increased to the day before & the day after. My current Rheumy directs it as 5mg every day except the day I inject. It does appear that each Rheumy has their own preferences but generally the dose is increased if side effects are becoming problematic.

It is a B vitamin but it's thought that taking too much can deplete how efficient MTX is, hence not taking it the same day as your MTX. As your Rheumy directs you only take it the one day he's probably thinking the dose you're taking extraneously won't be high enough to cause any problems. Only my take on it but again your blood results will tell, your FBC will drop if you're taking too much so if your levels are ok, your Rheumy's happy with you supplementing your intake & you think it's helping there's no reason to worry. The only thing I would consider, though I don't know the daily dose you're taking, personally I wouldn't take it the day you take MTX & do remember that it's fortified in most breakfast cereals & occurs naturally in leafy greens, brocolli, avocado, oranges & quite a lot more so if you eat a healthy diet you'll probably find you're taking enough in naturally.

This link will explain fully about the different B vitamins nhs.uk/Conditions/vitamins-...

I hope all this helps & not confused you even more! ;)


Just to add to the replies you've already had, I think of my body as a highly tuned, high performance (!) machine that needs all sorts of different oils, greases and petrols to make it wrk perfectly....(shows I've spent too long watching people with their heads inside cars tuning up engines). So you need the full range of different B vitamins to function brilliantly.

But with most of them you only need a tiny dose - so the ones you buy from the health food shop are probably in micro-grams (ug) rather than the folic acid you're prescribed which is probably milligrams (mg). But even so it's best to steer clear on MTX day to allow it to work fully.


I'm very impressed by this helixhelix. Will try to be more attuned to your way of thinking rather than viewing my body as a clapped out old banger that just about keeps going, on a good day. (I've spent rather too long with my head under bonnet of those types of vehicles).


Beauty is in the eye of the beholder.... I saw clapped out banger, OH saw some kind of dream machine. But my preference would be for a sleek classic car, elderly but with elegant lines, and not prone to going too fast! And certainly worthy of lots of TLC...


Perfect description of my husband's and my opinion on cars. We have hulk of a 1956 Jaguar in our garage taking up to much valuable space. Sorry if I'm off topic.


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