Folic Acid

[KMC21]

Hi, can anyone advise please, my son was diagnosed B12 deficient last year, had loading dose and then every 3 months, 2 months ago, neurological symptoms returned worse than ever, blood tests revealed folate was at 3 and found out that last year when he was diagnosed it was only at 6, yet no folic acide was prescribed at that time. This time doctor prescribed 5 mg per day for 2 weeks, then checked blood and said it had moved up to 20 and that would be fine, no need to continue. He received loading doses of B12 again and is now on 1 per month..My question is should he be continuing to take folic acid on a daily basis to support the B12 and if so, how much should he take?

Thanks

[Secondchance]

Hi that is great that the GP prescribed loading doses again and folic acid. You need folate to be able to use B12 properly. Yes his folate level will be OK now but may reduce again whilst taking B12. I would suggest taking methylfolate 400mcg (available on amazon) and a good B complex for a day or two around injection time each month and keeping and eye on the folate level. Methylfolate is better than folic acid as it is a more usable form of folate. Folic acid is a synthetic version which the body has to then convert to folate- some people have difficulty with this. There has also been some association between folic acid and cancer- most likely long term so don't worry about 2 weeks use. One less step to worry about if you take methylfolate.

Ideally his GP would have continued loading doses if he has neurological symptoms until no further improvement or at least until 3 week review (BCSH guidelines):

onlinelibrary.wiley.com/doi...

If your Gp is prescribing more loading doses and monthly they are already working well with you and thinking outside the one size fits all. Keep them!

All the best to your son for a recovery now that he has more treatment.

[engels in reply to Secondchance]

Methyl folate is being recommended a lot on this forum at the moment but I am concerned that no mention is made of the unpleasant side effects which some people experience. This is a good summary - mthfr.net/methylfolate-side...

[Secondchance in reply to engels]

Thanks for posting this. I was not aware of this, so always good to learn. I have acne which I attributed to B12 but maybe it is due to methylfolate?! I don't have any of the other side effects. Anyone else? Just about everything I have read suggests it is better than folic acid, although obviously important to keep all B vitamins in balance. Mmmm, more reading to do now...

[KMC21]

Thanks for info, i should have said he is also using B12 spray twice a day everyday, so would this affect his folic acid or should he still just stick to supplementing around time of monthly injection.

[Secondchance in reply to KMC21]

He should continue B12 spray too as that will keep him topped up in B12 between injections. Another alternative is sublingual tablets.

[shevie]

Yes he should take Folic acid in order to maximise the efficacy of the B12 shots

Or get him some methylfolate if you prefer

[wedgewood]

I would say yes,as the folate is necessary for absorbtion of B12 . Best of all get daily folate from fresh green veg(peas and leaves) Next best is folate called Metafolin,which is nearest to natural.Folate is superior to folic acid.

[Polaris]

Info and advice on folic acid in this video KMC21:

b12deficiency.info/films