Box 3 Summary of treatment and management of #b12d Why Start folic acid 5 mg daily after B12 supplementation

what about the significance of B12 converting to B12 analogues when folate low. Why have loading doses when B12 analogues will decrease active cobalamin. It doesn't make sense. Is there paper that describes harm of b12 & FA given at same time to correct both deficiencies? A Dr not seeing haem response to confirm B12d post injs might dismiss B12d if no folate given. The haematologists G'lines cite klee. which Dr Harrington has used on his paper, Both BSCH guidleines and Dr Harrington paper have misinterpreted the masking of b12d with folate treatment .

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  • I think giving folate after B12 is sensible advice given my research. Giving folate alone may precipitate subacute combined cord degeneration. Giving folate with B12 will allow B12 to be used most effectively as B12 and folate are co-dependent in many biochemical processes.

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