Pernicious Anaemia Society
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My friend has been suffering from tiredness. He's had a blood test which showed his b12 levels to be 'normal' and his folate to be 'slightly' low.. His Dr advised him to buy folate supplements over the counter. Can any one advise which and how much folate he should take. I'm concerned with his result of 'normal' b12 level and wondered if he should supplement this too, he's fifty years old and six foot three!

7 Replies

My advice would be to NOT take ANY supplements until getting hold of a written copy of his blood results and posting them here. It will be more than worth the tenner or so it will cost, and more than worth the extra few days wait

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Bear in mind that in the U.K. the "NORMAL" levels of B12 can be as low as 200! In Germany and Japan ,below 500 is treated with B12 injections. I had a level of 150 with symptoms of dizziness, confusion, exhaustion,and numb feet, and not given any treatment! I had to go to a private G.P. to get a diagnosis.Yes, I agree with previous comment, not to supplement until you have the printout of the blood tests.You need good levels of folate also. Come back here afterwardS. There are some really knowledgeable members who will help you.In the meantime, all the best!


He's Folate count Is 4.3 and he's B12 is 252. He takes Eviplera 200mg one per day.


I believe B12 252 is LOW, but the NHS will say that it is normal!!!!! Damage can occur at this level. If he doesn't have P.A, (anti-bodies to the Intrinsic Factor should be tested for) supplementing with B12 sublingual lozenges would help(Amazon) Also B12 patches and nasal spray could be tried. If he has P.A. (mine was diagnosed by private G.P.) then injections are probably the best solution. Keep us informed! All the very best.



I've assumed you're in the UK

It is possible to have severe B12 deficiency at the levels your friend has. Even though this levels would be considered normal range in the UK.

Recent articles have made it clear that patients who are symptomatic for B12 deficiency should be treated even if their B12 blood test is normal and IFA tests are negative.

I found the books/articles/documents/websites below helpful.

pernicious-anaemia-society.... 01656 769467

If you leave a message they will get back to you.

Google "BCSH Cobalamin and Folate Guidelines" I found page 29, a diagnosis flowchart useful.


Could It Be B12 by Sally Pacholok

Pernicious Anaemia;The Forgotten Disease by Martyn Hooper

Living With Pernicious Anaemia by Martyn Hooper

"His Dr advised him to buy folate supplements over the counter."

Taking folate without treating a co-existing B12 deficiency can mask symptoms of B12 deficiency. If B12 deficiency is not treated it can lead to severe neurological damage, sometimes "sub acute combined degeneration of the spinal cord"

Links below may be helpful.

Scroll down to "Management" section.


My friend is taking Hydroxocobalamin 1mg in 1ml solution for injection once every two days for ten days. Can you tell me how much Folate he should be taking as the his Folate came back as low. Thank you.


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