Best Supplements for B12 & Folic Acid?

Hi,

Recently diagnosed with B12 & Folate deficiency and so far just told to take multi-vits containing B12 and Folic Acid.

Asked in pharmacy for best ones to take and they just said a general A-Z multivit so that's what I've been taking for the last 2 weeks.

I've only just found however that the A-Z multivits contain just 2.5µg B12 and 200µg Folic Acid which is 100% RDA.

I've just found though that Berocca is perhaps a better supplement to be taking as it focuses mainly on B Vits and contains 8.6µg B12 (344%) and 366µg (183%).

Can anybody recommend anything better off the shelve from a chemist/supermarket from your experience?

Thanks again

16 Replies

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  • How old are you?

    Are you a vegetarian or vegan?

    Meat is the source of B12 if your gut is working correctly?

    Green vegetables- broccoli and kale are good sources for folic acid.

    One has to ask why have you become deficient? What are the numbers?

    Any recent Stress, anesthesia, dental work?

    Methylcobalamin sublinguals 5000 mcg are pretty good but I self inject cyanocobalamin weekly and use them to fill in. This is in addition to taking extra folic acid and the centrum silver 50+ multivitamin. They all work together.

  • Hi, pvanderaa,

    I'm Late 20's, have a healthy daily supply of meat/animal products (at least I thought I did! - I don't exactly have rationed portions!).

    I love broccoli and have that a couple times a week. Not so much kale, used to have that a lot in smoothies but went off it.

    No idea why I'm deficient, I would argue it's not diet related. Folate & B12 were 2.9 and 160 respectively 2 weeks ago.

    Stress - Yes.

    I had a General Anaesthetic in February of this year. No operation was actually performed though.

  • Hi iStevie. I've just left a reply to your previous post (earlier today).

    Bearing in mind your symptoms and the really low levels of B12 and folate you have, I think you need to go back to your GP. This kind of supplementation will not 'fix' your deficiencies. You need B12 injections.

    And....your folate and B12 arereally very low - please do not supplement with folate until your B12 level has been raised (the dose from tablets will not do this). B12 and folate work together so,you need good levels of both but if you raise folate levels first, without having good levels of B12, you are at risk of potentially irreversible neurological damage.

    Your GP does not appear to be serving you well 😖.

    Please see previous reply for fuller explanation.

    👍👍

  • Hi Foggyme,

    Appreciate your replies.

    It's really scary when you walk out of a GP practice with results not really knowing what B12 is or Folate, with a Dr being so unconcerned only to stumble across a forum such as this with people that have been through the mill.

    GP wrote down on a scrap piece of paper - "B12 a bit low, neet to get up, Folate a bit low too, need to get up. Take Multi-vit & eat animals".

    In fairness to GP, she said the Lab would not allow her to request another B12 or Folate test for 3 months, i.e. 3rd February - She said if she did so beforehand they would refuse her so I just need to book in for a blood test in February to get levels rechecked.

    The Multi-vit i'm taking (as of today) is Berocca, which has 344% RDA of B12 and 183% RDA of Folic Acid - Does that seem the right ratio to you i.e. making sure i'm intaking more B12 than Folic Acid?

    Thing is re. going back to GP, I'm really nervous/anxious/worried about doing so - I have an appointment first week in 2 weeks I know I will end up just waiting until then. I hope I have the confidence during that appointment armed with all the resources I've been given on here to get what I need out of that appointment.

    I get the impression the GP may have felt my symptoms were more related to Depression than Depression with those other symptoms being related to B12!

  • Agree with Foggyme - you need to be treated - now, not in a few months time.

    For B vitamins you can't really beat Tesco multi-B tablets. 100% RDA (more isn't better - it can be a lot worse) and a good price.

    Normally, I would advocate their folic acid tablets as well. but there are, as Foffyme states, reasons why one shouldn't supplement with high-dose folates while one has a B12 deficiency. But check them out once your doctor has started yo on a course of B12 injections.

  • Hi again iStevie. The first and very obvious thing is...you need treatment with B12 injections...and you need them now. Here's why.

    It has been proved that you have a B12 and folate deficiency. You have neurological problems (issues with cognitive function - and perhaps others that you do not mention). All the guidelines state that where neurological symptoms are present, treatment with injections should commence immediately to prevent potentially irreversible neurological damage.

    To put this in context: serum B12 levels need to be over 1000 for neurological repair to take place (mine run at over 2000 and I intend to keep them that way). The absorption rate from tablets is 1% at best (and if you do not have an absorption problem). Your levels will never reach 1000 if you are only taking the tablets. Absorption rate from injections 100% - levels should soon return to neurological repair levels.

    And I've just spotted something in one of your earlier posts that gives rise to concern. You mention the possibility of autoimmune disease and the fact that your inflammatory markers are raised - but your GP has no plan! Raised inflammatory markers could be due to temporary infection but with everything else going on, this is unlikely. You should be investigate for potential autoimmune conditions (for instance, Hashimoto's thyroiditis often goes hand in hand with pernicious anaemia).

    You asked previously if we thought your GP's advice was sound - no, most definately not.

    Your GP should be investigating to find out why you are B12 and folate deficient (for starters). Autoimmune conditions run in families and if you have one autoimmune condition, you are more likely to have another. Pernicious anaemia is an autoimmune condition - your GP should check your anti-Intrinsic Factor antibodies (if these are positive, you have PA - if they are negative you could still have PA - test only 50% accurate).

    GP should also run FBC (looking for macrocytic anaemia - large red blood cells - sometimes (but not always) present on pernicious anaemia.

    GP should test ferritin levels (low ferritin often found in B12 deficients. Note - low ferritin produces small red blood cells. If present, these 'cancel out' the large red blood cells found in macrocyclic anaemia - so your cell size may look normal, even if it's not.

    GP should check vitamin D (your lightheaded could be due to B12 / folate deficiency, anaemia, or low ferritin / vit D - only way to know is via blood tests.

    GP should also check ANA (anti-nuclear antibodies). Diagnostic tool - won't identify specific autoimmune conditions but if positive, will indicate that further investigations are required - usually via a rheumatologist.

    So iStevie...this has been a long way of saying...your GP is wrong...you need treatment with B12 injections. Now.

    Something to keep in mind - your GP may think that giving you B12 tablets and simply nudging your B12 levels into the bottom of the reference range is sufficient. It's not. Just keep in mind the 1000 level required for neurological repair.

    I note from your other replies that your printing information from the pinned posts to take along to your GP - well done 😀.

    It is very scary having to challenge GP's who can often be intimidating, especially when they don't have enough knowledge about what they're dealing with (as is often the case with B12 deficiency and pernicious anaemia). So you might have to be brave. And insistent. But it's your health. You deserve to be treated properly so that you can Reagan your health and avoid further damage.

    Some people find it works to take along someone for support and to act as a witness (especially if they're willing to read your information and jump in if you get foggy). GP's are often more attentive and less hostile if there is a witness in the room. Sad, but true.

    Anyway, sorry if I've been a bit 'long' - I really do hate it when GP's 'fall-short' and people are left to suffer.

    Very best of luck and please ask again if you need any further information or support.

    We'd be really interested to hear how you get on 😀

  • Hi Foggyme,

    Given my current 'cognitive function impairment' I just want to start by saying thank you for taking the time to explain yourself, and for going back other my previous posts/comments and consolidating a response - it makes sense to me what you're saying and I found your response easy to digest!

    Makes perfect sense how you've explained it re. B12 levels needed to affect repair. I've written this down to reference during my next GP appointment. - On the back of what you, and others have said, i'm going to try and bring that GP appointment forward too!

    I don't suspect Hashimoto's as TSH was 0.9 which I understand if anything is borderline hyperthyroidism.

    I believe Celiac was ruled out during my tests, as the lab made a comment on the report that one of my result would make Celiac an extremely unlikely diagnosis. (can't remember which).

    As well as low B12 & Folate, High CRP & PV I also had the following results in answer to your questions which I never mentioned because GP said they were normal:

    Ferritin 85ng/ml (RR 25-350) - GP said it was absolutely fine.

    GP said my cell size was normal however I have gone back and checked results and its slights on the smaller side of normal (outside of lower RR)

    Red cell count 6.46 (RR 4.5-6.5)

    MCV 79.5 (RR 80-100) Small cell size, not normal.

    MCH 25.8 (RR 27-32) Low Hb

    I know this is the opposite of what you expect with PA. I've read that having a high inflammation level within the body can actually inflate your Ferritin levels, so I have come to my own conclusion that I am Anaemic and my ferritin is showing as low normal on my serum test because of high inflammation increasing that number, and in truth if it weren't for the inflammation I feel that would be a lot lower - kind of backed up by small cell size as you mentioned, which may be cancelling out the expected large cells that would be expected by PA. I think I've understood you and I think that seems quite logical!.

    I've taken on board your comments re. my GP being wrong - I've struggled with the notion of questioning my GP as I've always respected them but you've given me the confidence (at least today!) to make an action plan before my appointment and take control over my treatment! And to make sure I get my levels above 1000 and persist until I do.

    Please don't apologise for your long response, It's clear, concise, easy to comprehend which believe me I appreciate more than anything!!!!

    I even signed up to Babylon Health, the iPhone app, at £4.99 a month so I could have a chat with a GP to discuss my results for a second opinion - I thought I would find it easier to see what their response would be first, and they just, in short, told me my results were contradictory and required repeating but "every GP is different!" and they agreed my GP's action plan (or lack thereof) was sensible and sufficient. - Pfftttt!

    I will certainly keep the group updated with progress. Thanks again :).

  • It is not the TSH that confirms Hashimotos - but the testing of the anti-bodies - ANTI-TPO & ANTI-TG. If you have Hashimotos you can swing between Hyper and Hypo .....

    For correct thyroid diagnosis you also need the FT4 & FT3 tested.

  • Hi iStevie. Really pleased that the words were useful and that you're begining to get a handle on this 😀. Only way to 'combat' ill-informed GP's is to become informed - and you're certainly doing that.

    Love your logical analysis of the blood 'situation' and agree with the 'pffttt' awarded to Babylon Health - though I can understand why you approached them. How sad that it should be necessary 😖.

    Would also agree with Marz about the thyroid testing. GP's only usually bother to test TSH so worth having another argument with your GP. Or you could always get these done privately if your GP absolutely refuses (Blue Horizon Medicals is one place but there are others if you search the Internet). Incidentally, if you get all the results and post them in the thyroid forum (to which Marz belongs) here on HU, then folks there will help with interpretation (GP's most often get this wrong too).

    Very best of luck iStevie...very interested to hear how it goes 😀.

  • Hi Stevie,

    Natural methylcobalamin & hydroxycobalamin are best absorbed, with no cyanide compound to break down by the liver. I usually eat mine from kefir, but have just found my levels aren't as good as I expected, perhaps due to my age. I've just started Solgar vegetarian/vegan sublingual methylcobalamin to seee if that will perk me up a bit.

    Folate is also better than folic acid, so eat more greens, or take a folate or metafolin supplement. Solgar, & a few other companies make this too, but I avoid their multi-B complex' as they contain cyanocobalamin, but labelled as cobalamin on their new labels.

    I avoid the fizzy B's as they contain artificial sweeteners that are bad for good gut bacteria, so are likely to further impair B12 absorption.

    Mel

    ps Please see my other reply as to why I wrote this. :)

  • Natural methylcobalamin & hydroxycobalamin are best absorbed

    No they're not. All forms of B12 are equally well absorbed.

    with no cyanide compound to break down by the liver

    The amount of cyanide in 1000 ug of cyanocobalamin is miniscule - the same as in one-fifth of a glass of prune juice.

    Folate is also better than folic acid

    In what way?

    For the vast majority of the population folic acid is actually better as it has a higher bioavailability.

    they contain artificial sweeteners that are bad for good gut bacteria

    Only in that they do not provide plenty of sugar for those bacteria. But that's not going to be a problem for anybody eating properly.

  • I would say folate which is obtained through green leaved vegs primarily ,is better than folic acid because you get so many other beneficial nutrients that accompany it e.g. Calcium . Iron, magnesium, phosphorus , potassium . Zinc Fibre. and so on .

  • Apologies for not backing up what I wrote with why.

    Re B12, there are lots of other articles available:

    naturalnews.com/027045_vita...

    Re taking folate stated natural was better than synthetic.

    chriskresser.com/folate-vs-...

    Re artificial sweeteners:

    chriskresser.com/how-artifi...

  • Any proper scientific stuff?

    Like this one - that says that methylcobalamin is no better than any other form - ncbi.nlm.nih.gov/pmc/articl...

  • No, but thanks for the information.

  • Hi boots or tesco alternative to berocca its the B active. its half the price of Berroca and contains the same ingredients . I am using that and also you can use Lanes preconceived 400 micrograms folic acid tablets. I was prescribed these by my doctor and redo blood test in 3 months . Hope I've been of some help to you.

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