The Folate Trap: I had low folate and... - Pernicious Anaemi...

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The Folate Trap

ladydawny profile image
6 Replies

I had low folate and supposedly low normal b12. A doctor told me to take b12 first because of the 'folate trap'. He said if you get folate repleat it can disguise a b12 deficiency. I am not exactly sure what it is all about can someone please explain the term 'Folate Trap' for me?

Much obliged.

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ladydawny
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Gambit62 profile image
Gambit62Administrator

Its all down to confusion and misunderstanding and thinking that the symptoms of b12 are caused by blood disorders when the blood disorders are actually symptoms of B12 deficiency.

Having high folate can result in smaller blood cells.  This counteracts the macrocytosis that is caused by a B12 deficiency and hence masks this one symptom.  However, there are a lot of other symptoms ... and macrocytosis isn't a prerequisite of a B12 deficiency.

There was a period when guidelines were poorly worded in the UK and it looked as if you shouldn't treat a folate deficiency if a B12 deficiency was present.  Think the current guidelines are a bit better expressed and make it clearer that a folate deficiency should not be treated on its own if there is a possibility of a B12 deficiency - both need to be treated simultaneously.

ladydawny profile image
ladydawny in reply to Gambit62

Thanks ever so for that, it is clearer now :)

Sleepybunny profile image
Sleepybunny

Hi,

This link  may help. See Management section.

patient.info/doctor/folate-...

ladydawny profile image
ladydawny in reply to Sleepybunny

Thanks very much :)

ladydawny profile image
ladydawny

I had noted that with my being iron deficient also (I have many deficiencies as I suffer from Hashimoto's and Addison's disease which went undiagnosed for years) that the smaller sizes of the red blood cells due to iron deficiency masked the average sizes of larger cells from the b12 and folate problems.

Sleepybunny profile image
Sleepybunny

Hi,

Other links that may be of interest.

patient.info/doctor/macrocy...

patient.info/health/vitamin...

labtestsonline.org.uk/under...

patient.info/doctor/full-bl...

UK B12 websites

pernicious-anaemia-society....

b12deficiency.info/

b12d.org

martynhooper.com/

B12 books

What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency by Martyn Hooper

Could it be B12?: An Epidemic of Misdiagnoses by Sally Pacholok and JJ. Stuart

UK B12 documents

ukneqas-haematinics.org.uk/...

bmj.com/content/349/bmj.g5226

Google "BCSH Cobalamin and Folate Guidelines"

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