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Pernicious Anaemia Society
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B12 higher than before and folic acid lower?

Hi everyone, as I said before my B12 went from 189 ng/L in July to 283 ng/L in January, without taking any supplements. Due to my psychological and neurological symptoms, my GP still put me on weekly injections for about 10 weeks, and I've got my second one today.

When I looked at the blood results from January, I saw that my folic acid had dropped from 10 in July to 4 in January. I don't understand how it is possible that my B12 had risen and that my folic acid went down?

8 Replies

B12 and folate do work together and it is not unusual for folate levels to drop when B12 levels improve. Did your GP prescribe folate or folic acid? if not you need to supplement yourself. You may not see much improvement due to the B12 injections until your folate levels are higher, but don t be discouraged, hopefully you are getting there. Warm wishes.


a) were the ranges associated with the B12 test the same - if different pieces of equipment were used that can affect the measurement. There will also be some general variation in the test levels anyway, though the variation the rise looks a bit large to be down to testing variance.

b) B12 serum test isn't really that good an indicator of what is going on and results will vary anyway - not necessarily related to diet. Good on your doctor for pursing things on the basis of symptoms.

c) folic acid levels are much more related to diet as it isn't a vitamin that is stored - unlike B12 which is stored in the liver. Again - you need to know what the ranges were as results can vary depending on assay method.

d) although folate and B12 are used together there are things that use more folate and some processes that only use folate - the two aren't directly related.

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Do you think I Should take folate supplements with these levels? My gp says this Isn't necessary, but don't know it this is true


the best form of folate is definitely diet. Difficult to really comment on the folate without having the test ranges but if you look at your diet and find it is rich in folate rich foods then you could try adding some folic acid -200- 400mcg from chemist or suppermarket.


My folate was 4 and the lab ranges were 3-60!


suggest you discuss again with your GP - particularly if you are taking any SSRIs for the psychological issues (class of anti-depressants) - as these can lower folate levels in some people. As per pugdogs10 folate is needed for the body to fully absorb and use B12 so being folate deficient - and looks as if you are starting to head that way - possibly as the body is using more to deal with the B12 it now has.

would recommend looking at diet anyway - and the doses used to treat a full blown folate deficiency are much larger than those I've suggested but seem to be about the order that helps those that decide they do need/want to supplement.


I'm not taking any SSRI's, I'm hoping the B12 Will help my anxiety. I've seen Holland & Barrett has Some folic acid 400micrograms tablets, could this be helpful?


yes it's quite a common dose for people to take - though I'd look to see if you can get it cheaper at a supermarket.


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