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Getting confused Should it be Folate or Folic Acid with B12 injections please?


I wondered if anyone can point me in the right direction please, I've had 4 b12 injections now and not seeing any difference yet apart from some spots!:) I requested a folate test alongside ferritin, thyroid and IF, but not sure until I pick up printout if I'm low in folate, on last testing it was 7 in a range of 2.7-15. Receptionist couldn't seem to find that result, so hoping it was done! 

I'm not sure if I should be buying folate or folic acid, is folate a methylated form if folic acid. I am getting quite confused which really doesn't take much these days!vand would appreciate any advice please.

My ferritin came back at 24, one Mark above range so has obviously dropped from 142 last august (not sure if that was accurate tho as I'd had a lot of infections, but had been supplementing for 7 months as it was 12 originally)

Thyroid tsh has also gone up to 3.18 (0.35-3.5) and f 4 dropped to 13    . These results were after 2 injections.

Any thoughts on folate would be much appreciated, I only have limited time on the comp at the mo due to migraine,dodgy eyes!

Thank you...Jo

12 Replies

Folate is vitamin B9 as it occurs naturally in green leafy vegetables. Folic acid is a synthetic version which is the usual kind found in supplements. It is possible to over supplement with folic acid ,which is not advisable. It can mask B12 deficiency. There is a methylated  version called Metafolin which is superior to folic acid, but unfortunate much more expensive. So ideally try to get your B9 folate from natural sources.  B12 and B9 work together and need eachother to do their job.  Hope that this helps.  Hope that you feel better soon. 


Many thanks for your help Wedgewood. I think I do eat plenty of foods containing folate, but will try to add more if I can. I was concerned that having b12 in such high quantities might not be adequately matched with foods alone. 


Inject 1mg B12 every week' I only have folate from foods,except when for some reason I think that I haven't had much folate. Then I supplement . I find that is sufficient  i.e. I don't get any recurrence of symptoms . I don't get tested,because I never go to my doctors now---I'm in the doghouse because I told her that I was self-treating. . This is frowned upon, but I don't care. My health is more important to me than keeping in my doctor's good books.  Many people supplement by injection with quantities far in excess of the RDA.I don't think that they do the same with B9(folate) There is no danger in supplementing B12 in large doses, but I'm not so sure about B9.


Thanks very much Wedgewood, I've rebooked into folate to make sure I'm eating plenty. Can increase pulses a bit more, as have pushed them aside a bit after trying to eat more meats and fishes for the b12 and iron! I eat loads of vegetables and salads, but it's good to freshen your mind and keep an eye on it thanks.

I'm glad you've found a way of treating yourself and are keeping well. You're left with little choice if no one will listen.Keep well...thanks again Jo


Keep up the good work Jo54554!You will get there if you persist. I'm really glad if I have helped in any small way Best wishes


Oops it went before I was finished!:) thanks for your description and good wishes...



It's even more complicated if you're a chemist because then folate = folic acid.

However, in the rest of the world folate refers to a general class of compounds related to folic acid. However, it is normally used as a shorter version of methyltetrahydroflate which is also known as methylfolate (or the trade name Metafolin). No wonder you're confused.

Normally we humans get all the folate we need from natural sources. But some problems can mean we require more. Folic acid is quite cheap to manufacture and the vast majority of the population have no problems at all converting it to methylfolate.

However, some people do have genetic mutations that mean they're not so good at the conversion. They still do it, but at a reduced efficiency. For these people taking methylfolate it the best way of supplementing.

How do you know you've got these mutations? Well, you need to have your genes decoded. It's relatively expensive (£125 - 23andme.com/en-gb/) but it gives you lots of other interesting information.

For most people it's a matter of deciding whether to take folic acid or spend more on methylfolate. There's no harm in taking methylfolate at sensible dosages, and the same applies to folic acid. 


Thank you fbirder. I do tend to eat a lot of foods containing folate but my results are usually barely mid-range, do you think that's a sign I don't convert it very well or do you think it would be much lower if that was the case please?

I keep reading posts about the gene test, is it that that also tells you which type of b12 suits you best?

Also, I was looking into some different folic acids/folate yesterday and spotted a vitasorb one thinking it may help to avoid the stomach? They said that their folic acid originates from glutinate ( hope I've got that right, I tried to remember and not sure it's that now, but I know you'll know!) which is chemically processed into folic acid and doesn't originate from any particular vegetable/ foodstuff. But another brand said theirs originates from lemons. Just wondering if you can tell me if this varies from brand to brand or if there is just one way of processing it please. The reason I ask is because my latex allergy means I have to avoid  a few types of fruit/ veg.

Many thanks Jo


If you eat foods rich in folate then you'll be consuming folate (in some form or another) which is much easier to convert to methyltetrahydrofolate (MTHF). Also - I've no idea what the 'folate'' test actually measures - folic acid (in its ionised form, which a chemist would call folate) or MTHF or some other kind of folate, or all of the above.

The genetic test I took looks at loads of different genes. It can tell you what biochemical processes your body may not be so good at. However, as far as I can tell, there's nothing in the genes they test that determines what type of B12 would be best for you. I'm sure that some of it must, to some extent, be determined by genes, but they obviously don't know which genes do what - yet!

If they say it's folic acid, then it's folic acid. It matters not one jot where it comes from. If you decide to go for folic acid as a supplement (and there's probably no reason not to) then I'd go for the cheapest and check there's no unreasonable extra stuff.


Many thanks fbirder, sorry for slow reply was waiting for my folate results to tell you, just told today they forgot to do it after all, so am booked in for Friday, also didn't do the parietal antibodies and the IF were negative. 

I noticed the MCH had gone up to 32.5 (0.5 overrange) and highlighted, this was after 2 injections, but Dr didn't mention that. Thyroid TSH also gone from being nearly bottom of range last time to nearer top of range this time.

Have noticed a bit of improvement since my 6th injection on Fri so that's hopeful! Let's hope it continues...

My Dr said I def haven't got PA because of the IF and my Active B12 would have been under 25, mine was 27, but I did re-explain ( don't think that's a word, but it'll do! ) that it's only correct 50% of the time. I explained St Thomas felt it was worth investigating the cause of my low weight and possible malabsorption issues with having low B12, ferritin and vit d, so he's referring me to the hospital.

Are you noticing a difference since changing your folate? Hope so...thanks again Jo


Hopefully, St Thomas' will sort things out.

I have noticed a difference since I switched to methylfolate. But that's probably because I'm part of the 9% of the population that doesn't have the proper MTHFR gene. So my body isn't very good at converting folic acid to the usable form.


You said you received 4 injections, but over what time span? Two months? Three months? Talk to your doctor before buying supplements such as folic acid Because It can skew test results. YES, it DOES make B 12 work better! But it could deprive you of the help you need. Perhaps the strength of the loading dose is to low or the type of the loading dose is to blame. I don't know what country you live in, But here in the US, we have three types: Cyano, Methyl and Hydroxo. Perhaps you will do better with a better type of loading dose of B 12 that is available in your area or maybe you need a higher strength. Or maybr you need to undergo some other tests because you may have some underlying health conditions that are preventing you from utilizing the B 12 properly. Using other supplements, vitamins and certain medication can interfere with this as well. Perhaps you can talk to your doctor about this. Or maybe you need more frequent injections. Having low folic acid levels can mimic low B 12, so maybe your drficient with that. Its a bit of a catch 22. If you buy folic acid yourself, you'll feel better a lot quicker, but you may be taking an amount that isn't suited to your needs. You may be taking a lesser amount that isn't beneficial to your body's requirements. I would wait and have your doctor test your folic acid levels and have him or her tell you exactly how much to take. That way your taking the amount you should, as opposed to going to Walgreens, buying a bottle and hoping for the best. (Hoepfully the B 12 injections won't skew the folic acid test results though. There is a chance it could, so I'm not sure about this. Perhaps someone on this thread can clarify this)...


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