High Folate

[MariLiz]

Hi everyone, just got a printout of my last blood test results, and discovered my folate is over range ( range shown as 4.0 to 20.0). Mine was 24! Can anyone explain what this means? Have been told "no action" by the GP, well by the receptionist actually, when I phoned for the results! Chances of actually seeing the GP to discuss this are slim, as we go away for a week on Monday. All info and advice appreciated. MariLiz

[Hidden]

Hi MariLiz,

Are you taking a multi vitamin? Or do you eat a lot of cereal, they contain added vitamins, folate etc. Or do you eat a lot of veg? Your folate is not that much to high, better high than to low, I'd not worry!

Kind regards,

Marre.

[MariLiz in reply to Hidden]

Hi Marre, I have cereal most mornings, and take a multivitamin once a day. Also love to have steamed veg with my main meal. I guess I'm just getting a good supply. I wondered if it mean't it wasn't being used? Thanks MariLiz

[Hidden in reply to MariLiz]

As far as I know serum folate levels rise and drop very quickly (over 4 months) so it seems most likely to me that you just have a good supply of folate because of your diet, the artificial folic acid found in cereal and vitamin supplements can stay in the body, not doing much, it is currently unknown if this causes harm, some research implies it does good to have a high serum folate status, other research implies some possible harm, not enough research; see:

Cancer Incidence and Mortality After Treatment With Folic Acid and Vitamin B12

jama.jamanetwork.com/articl...

And:

ncbi.nlm.nih.gov/pubmed/204...

More in this link on the old PAS forum, go to board index and then the section called info and research on the old PAS forum, you will see a topic called research that implies harm / vit B12 and folate/ cancer; see:

pernicious-anaemia-society....

But you are only just over so I'd not worry. Perhaps reduce the multivitamin to once every other day, or once a week (I take mine more once a week than daily) if you want to make sure all stays in "normal" range. How high is your serum B12? if that is low then the folate could not be used, but be trapped as folate needs B12 to be converted to a form the body uses.

Its all a matter of quality of life I think, but so much is still unknown, so you may be taking currently unknown risks if you go over ref ranges of normal.

[MariLiz in reply to Hidden]

Thanks again Marre, the second link didn't work unfortunately, saying it didn't exist anymore. The first was interesting, as they were seeing if the supplements would help people with heart issues. My Father died from Ischemic heart disease, so it is something that concerns me. My Mother died from cancer, so again a concern. I suppose we all have to die from something! I will reduce my multivitamin to every other day, but keep up my Vit C to everyday. My B12 was 516 at two weeks before my next injection.

I have been reading a bit about MTHFR, the genetic problem with methylation, and wondering if it might be something that has an effect within my family? It can stop folic acid being used effectively apparently.

MariLiz

[Hidden in reply to MariLiz]

Hi MariLiz,

This may interest you:

BMC Cancer. 2009 Apr 24;9:122. doi: 10.1186/1471-2407-9-122.

Dietary intake of folate, vitamin B6, and vitamin B12, genetic polymorphism of related enzymes, and risk of breast cancer: a case-control study in Brazilian women.

ncbi.nlm.nih.gov/pubmed/193...

Abstract

BACKGROUND:

Several studies have determined that dietary intake of B vitamins may be associated with breast cancer risk as a result of interactions between 5,10-methylenetetrahydrofolate reductase (MTHFR) and methionine synthase (MTR) in the one-carbon metabolism pathway. However, the association between B vitamin intake and breast cancer risk in Brazilian women in particular has not yet been investigated.

METHODS:

A case-control study was conducted in São Paulo, Brazil, with 458 age-matched pairs of Brazilian women. Energy-adjusted intakes of folate, vitamin B6, and vitamin B12 were derived from a validated Food Frequency Questionnaire (FFQ). Genotyping was completed for MTHFR A1298C and C677T, and MTR A2756G polymorphisms. A logistical regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs).

RESULTS:

Neither dietary intake of folate, vitamin B6, or vitamin B12 nor MTHFR polymorphisms were independently associated with breast cancer risk. Analysis stratified by menopausal status showed a significant association between placement in the highest tertile of folate intake and risk of breast cancer in premenopausal women (OR = 2.17, 95% CI: 1.23-3.83; P trend = 0.010). The MTR 2756GG genotype was associated with a higher risk of breast cancer than the 2756AA genotype (OR = 1.99, 95% CI = 1.01-3.92; P trend = 0.801), and statistically significant interactions with regard to risk were observed between the MTHFR A1298C polymorphism and folate (P = 0.024) or vitamin B6 (P = 0.043), and between the MTHFR C677T polymorphism and folate (P = 0.043) or vitamin B12 (P = 0.022).

CONCLUSION:

MTHFR polymorphisms and dietary intake of folate, vitamin B6, and vitamin B12 had no overall association with breast cancer risk. However, increased risk was observed in total women with the MTR 2756GG genotype and in premenopausal women with high folate intake. These findings, as well as significant interactions between MTHFR polymorphisms and B vitamins, warrant further investigation.

PMID: 19389261 [PubMed - indexed for MEDLINE] PMCID: PMC2684745 Free PMC Article

And:

Folic acid supplementation promotes mammary tumor progression in a rat model

ncbi.nlm.nih.gov/pubmed/244...

Abstract

Folic acid supplementation may prevent the development of cancer in normal tissues but may promote the progression of established (pre)neoplastic lesions. However, whether or not folic acid supplementation can promote the progression of established (pre)neoplastic mammary lesions is unknown. This is a critically important issue because breast cancer patients and survivors in North America are likely exposed to high levels of folic acid owing to folic acid fortification and widespread supplemental use after cancer diagnosis. We investigated whether folic acid supplementation can promote the progression of established mammary tumors. Female Sprague-Dawley rats were placed on a control diet and mammary tumors were initiated with 7,12-dimethylbenza[a]anthracene at puberty. When the sentinel tumor reached a predefined size, rats were randomized to receive a diet containing the control, 2.5x, 4x, or 5x supplemental levels of folic acid for up to 12 weeks. The sentinel mammary tumor growth was monitored weekly. At necropsy, the sentinel and all other mammary tumors were analyzed histologically. The effect of folic acid supplementation on the expression of proteins involved in proliferation, apoptosis, and mammary tumorigenesis was determined in representative sentinel adenocarcinomas. Although no clear dose-response relationship was observed, folic acid supplementation significantly promoted the progression of the sentinel mammary tumors and was associated with significantly higher sentinel mammary tumor weight and volume compared with the control diet. Furthermore, folic acid supplementation was associated with significantly higher weight and volume of all mammary tumors. The most significant and consistent mammary tumor-promoting effect was observed with the 2.5x supplemental level of folic acid. Folic acid supplementation was also associated with an increased expression of BAX, PARP, and HER2. Our data suggest that folic acid supplementation may promote the progression of established mammary tumors. The potential tumor-promoting effect of folic acid supplementation in breast cancer patients and survivors needs further clarification.

PMID: 24465421 [PubMed - indexed for MEDLINE] PMCID: PMC3897399 Free PMC Article

This article, link below states best to get natural folate, " take the nature-made form of this nutrient -- called methyl folate (and there are a few forms of that too). " see:

huffingtonpost.com/dr-mark-...

So I try to stay in the "normal" range with the extra folic acid I take, as I was deficient, but in your case I'd reduce your vitamin tablet to once a week, in the end you should get all your vitamins from a healthy diet, which you seem to have. I only add as I know I have mal absorption problems, was def in besides B12 eventually folate other B vits and vit E. I also believe in having a vitamin profile done so you know if you are deficient or not, need to add or not. A healthy diet is by far the best!

I hope this all helps you,

Kind regards,

Marre.

This article below states what seems most sensible re:

[MariLiz in reply to Hidden]

Thank you so much Marre, lots of information there. Will read up on it more thoroughly later this evening. Have been out all afternoon, so dinner to cook next. I've wondered if it's worth getting the test for the gene problem, if only to arm my sons with more information. Best wishes MariLiz

[Hidden in reply to MariLiz]

Very difficult this gene testing, if you have it done and then your children decide to have it done and then you all worry, possibly a good thing or not, if the results are positive.

[Gambit62 Administrator]

The only known downside of high folate levels is masking anaemia in B12 deficiency so if you already have a diagnosis of B12 deficiency it is a bit irrelevant. Interesting to see one of the articles Marre quotes as listing effect in masking effects on blood that could indicate other conditions.

The studies with cancer are showing a correlation rather than a causal relationship - and seem to highlight the need for further research to establish if the correlation is causal or relates to another factor, eg you might expect higher levels of cancer in people receiving B12 supplementation because the reason they are receiving supplementation is because they were deficient at one point and being deficient puts you at higher risk of cancer. So, it could be B12 deficiency that is the causal factor not the supplementation.

There is some evidence that, because B12 promotes cell reproduction it may not necessarily distinguish between healthy cells and those that have mutated with the result that production of both is promoted leading to eg larger tumours etc.

To give another example - I don't know if anyone has ever done it because it would be a daft study but you could correlate main language with suicide rates and you might come up with speaking Swedish puts you at higher risk, statistically speaking of committing suicide but that is quite different from saying that speaking Swedish causes people to commit suicide. It doesn't, but it does mean you are more likely to be living around the arctic circle and that is known to put you at higher risk of suicide because of the wide variations in daylight.

So, high statistical correlation is NOT the same as establishing a causal link.

I know it is scary but the same is probably true of the correlation between high folate and cancer as folate works with B12.

My folate was around 24 last time it was checked - I do supplement to make sure that I'm in a good position to metabolise B12. I think it was probably the lab that had marked the results as 'NO ACTION'

Personally it isn't something that I'm worried about. I listen to my body as well and these days it often asks for spinach - good for folate but lousy for iron so don't think I'm oversupplementing.

[MariLiz in reply to Gambit62]

Thank you for your reply Gambit. The more I read, the more there is to try and understand. I never realised how complex the whole situation is with regard to B12 deficiency. Also, how very little GP's seem to know about it. I am doing as much as I can to educate myself, and to help to heal myself, but I must admit it's a struggle sometimes. Especially talking to a GP with a very closed mind! This site has been so helpful to me. Thank you again MariLiz

[Ruthi]

I have been reading up on MTHFR after I happened on something that mentioned high folate and B12 (serum tests) being linked to MTHFR mutations. I had both at my last tests, but still have symptoms typical of B12 deficiency. From my understanding it is possible your raised folate is due to such a mutation. There are several mutation variations possible, which vary in seriousness, but if you have elevated homocysteine (spelling?) or trouble conceiving or carrying a pregnancy to term its worth looking at further.

There seems to be little knowledge in the UK about this relatively recently discovered problem, which came out of the human genome project. You would need to read extensively - and search hard for a specialist!

But the first thing is to stop your supplements and see if things go back to normal!

[MariLiz in reply to Ruthi]

Thanks for your reply Ruthi, I don't think I've ever read so much about medical issues, since I got my low B12 diagnosis. I am also hypothyroid, so symptoms from that overlap with low B12. I have felt better since I began the multivitamin, but if it is causing the folate to be too high, then I do have to be careful. As Marre commented, to begin genetic testing could actually cause more worry for all the family! My husband has been undergoing tests for a blood problem too, so I really don't want to cause any more worry. I think I'll just cut back on my multivitamin and see what the next blood test shows. I'd asked for a full thyroid test, but that didn't happen, only TSH! Maybe I'll have to pay for a private test to try and get a full picture on that too? Best wishes MariLiz

[Ruthi]

Sadly thyroid and B12 issues are not well cared for here.

If your TSH is in range then they won't test any further, regardless of symptoms. Are you a member of the ThyroidUK board here on HU? Loads of useful information - and access to discounts for private testing!

[MariLiz in reply to Ruthi]

Yes Ruthi, I joined the thyroid, pernicious anaemia and fibromyalgia groups together. I have to say I'm still not sure about the fibromyalgia diagnosis. It seems as though a lot of those symptoms can be caused by the low B12 or under treated thyroid. The whole process of being diagnosed with Fibro was fairly vague too, just a rheumatologist pressing a few tender spots and saying yes you've got Fibro! I don't think she'd even checked my blood test results till I reminded her to. No further appointments were offered either, just given Amitryptiline to take, and told to see my GP if it got worse. MariLiz

[Ctb567]

Mine had been high before too and I've been fine. Apparently the folate test is really easily influenced, if you've had anything with folate in near to the blood test or the night before then I've heard that this can higher the result. A bit over the range won't harm you

[MariLiz in reply to Ctb567]

Thanks Carly, I think you can read lots of things that seem to offer conflicting advice. In the end I suppose you are guided by what helps you, and how you are feeling. I have felt very ill, prior to getting the low B12 diagnosed. I had a bad flu infection, and was just flattened by it. I think I had two weeks of being either in bed, or on the sofa. It left me completely drained for about another month. I can remember the nurse doing the loading injections kept asking me if I was feeling any benefit from them! It took quite a while till I could say "Yes!" MariLiz

[hilly2]

I am a vegan and my folate was really high all the veg i eat i guess dont thinm its anything to worry about 😊

[Ruthi]

Mariliz, you need copies of the bloods you do have, although without a full thyroid panel and active B12 you will never know if you are adequately medicated.

Time to save up!

[MariLiz in reply to Ruthi]

Hi again Ruthi, yes saving up seems the only option! MariLiz

[Ruthi]

Depressing, but I guess I get reasonable value out of the NHS in other ways! They did a lovely job mending my broken leg!

What I really resent is being told I am depressed/suffering from mythical illnesses like ME/CFS/Fibro or best of all (but its said in code) just a little woman!

Come to think of it, wasn't there some recent research into Fibro suggesting that it is a genuine, testable, condition? I'll have to go look again. That'll cramp the doctors' style. They will have to think up a new title for DNGACS or 'Docs not got a clue syndrome'.