JUST A LITTLE QUESTION

[may61]

Should you take folate or at least a multi vitamin when receiving B12 injections ?Its a question I have asked both docs at my practice both said no Is this the right answer?

[wedgewood]

It is NOT the right answer ! It's so very worrying that doctaters( Freudian slip ? You decide) are so ignorant about PA / B12 deficiency It's very important to have plenty of folate /folic acid when supplementing with B12 . If you eat plenty of green leafy vegetables you will maybe get enough , but it is wise to take folic acid tablets or a vitamin B complex . B12 and folate /folic acid work together to keep us up and running . Best wishes to you .

[may61 in reply to wedgewood]

I thought was rite thanks

[Shawol1 in reply to wedgewood]

I have NEVER heard of taking folic acid with my b12 shots! I live in America, if that matters. Last night I'm pretty sure I hit a vein, it bled, has a bruise and today I'm having pain going up my thigh to my hip. I've been on hold for about 45 minutes - have talked to a nurse who says I should be okay, but she wants me to talk to a doctor.

I'm so glad I'm here, because it told me FIRST that I should be just fine (thank you!!😊) And SECOND that I need to take folic acid!! Why have I never heard this before? Now I need to research that as I sit on hold. Thank you for being here👍☺️

[wedgewood in reply to Shawol1]

I’m honestly surprised that your doctor hasn’t advised supplementing with B9 ( called folate in food and folic acid in tablet form . It works synergistically with B12 ) If you eat plenty of green leafy vegetables and other folate - rich foodstuffs , you maybe don’t need to supplement . But most people do not eat enough , and vitamin B9 cannot be stored in the body, so it’s best to get it on a daily basis. Best take a modest 400 mcg tablet .

WELCOME TO PAS HEALTH UNLOCKED FORUM ! 🤗

[clivealive Forum Support]

Hi may61 I'm not a medically qualified person but I understand that Folate is essential to process B12.

Personally I've been having B12 injections for 45 years and despite my taking 1 – Folic Acid 400μg every day for as long as I can remember, plus whatever in in the vegetables and fortified breakfast cereals I eat my level is still only just over 50% of the "normal" range.

There are others on here who will be able to give you good advice.

[may61 in reply to clivealive]

Thanks again Clive Am new at this and it is quite difficult to get your head round cos such a lot of conflicting info

[Foggyme Administrator]

Hi May61. Oh dear tour doctors are excelling themselves again. Not.

The first obvious question is...has your doctor checked your folate levels (be surprised if he has). He should especially if he's finally agreed to prescribe B12 injections for you. Your GP may well tell you this is normal when it's not. It should be in the top third of the reference range.

He should also check (at a minimum) FBC (to check for macrocytic or,other forms of anaemia, ant-IF antibodies (to see if you have PA - but the test is unreliable so you can still have it even if it's negative), ferritin (if too low, this will make you feel very ill- should be 80 - 100) and, especially during / after loading doses (certainly if you're on every other day injections), potassium, and vitamin D.

400ug of folk a acid daily is sufficient for most people (as per clivealive ) but if your folate is low, then you will certainly need more until,your levels raise. But only your GP will know that - if he tests your blood.

Many people take a multi-vitamin and mineral tablet daily, or a multi vitamin and a B complex daily (as @Wedgewood points out). I always check the RDA on the containers - some multi tablets contain much more than the RDA and I found that I was getting too much vitamin B6. And it's much more difficult to tailor doses this way, since you get something of everything, whether you need it or. So some people take individual supplements so that they can only take what they know they need. But it's not always easy to identify what exactly your individual needs are.

Be careful with vitamin B6 - if you have too much of that it can give you pins and needles throughout the body. Potassium should never be supplemented unless under medical advice (it can affect how the heart works) - most people get this from potassium rich foods.

And that brings us back to folate - too much folate can give you symptoms very similar to some of the symptoms of B12 deficiency (check out mayo clinic.com/folate if you want more information). And this is why your GP should check your folate levels...as you are rightly aware, B12 and folate work together so,if it's low your B12 won't be used properly by the body...but too much can give you some horrible symptoms 😖. Grief...it's just not easy, is it.

And you shouldn't have to pay a fortune for your supplements - tesco's do a good multivitamin and mineral (contains no more than 100% RDA so less risk of over supplementing). Though it has to be said, some folks prefer to buy from specialist health food shops (but I'm not good at those, so ask if you want more advice).

And this has been a very long-winded way of saying...your GP is wrong! Again!

If you do a search on this site for co-factors or the name of the particular vitamin or mineral you want advice about, lots of information will pop up so you can see what others have to say.

Its really sometimes really difficult to get the balance right with supplements so shout up,if you need any more advice.

Hope all's going better for you. Take care x

[Polaris]

I agree with Foggyme that your folate levels should be checked.

I notice that your B12 levels were very low so it could be better to wait until levels have risen mor as folic acid gets 'trapped', cannot be used, and could make any neurological symptoms worse :

"High levels of folate are normally okay as long as your vitamin B12 level is also normal. Cells need vitamin B12 to use folic acid and when vitamin B12 levels are too low, folic acid cannot be used and builds up in the blood." :

gbhealthwatch.com/Nutri...

............

cmim.org/pdf2014/funcion.ph.... :

"If there is noncomitant B12 and folic acid deficiency, then B12 must be started first to avoid precipitating sub acute degeneration of the spinal cord.

In patients with isolated vitamin B12 deficiency and anaemia, additional folic acid is recommended until vitamin B12 is replete to prevent subsequent folate deficiency after replenishment of B12 stores."

ncbi.nlm.nih.gov/m/pubmed/2...