Folate or Folic Acid ?

Hi, Can anyone advise if it is best to supplement with Folate or folic Acid when receiving B12 injections monthly, my son was initially given a course of folic acid 5 mg as his folate level was down at 3, but after blood tests it had gone to 18 and they stopped the folic acid. He has been suffering with extreme tiredness again and had his bloods done and folate was back down at 6.4. Doctor does not think its necessary to prescribe folic acid, but I feel it would help. Can anyone advise what is best?

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  • The best form of B9 - folate - definitely comes from food.

    Folic acid is one artificial form and the cheapest.

    There is a lot of hype about the benefits of methylated forms of B9 over folic acid and true that there are some genetic variants that mean people don't convert folic acid to the methylated forms used by cells for some processes as efficiently but that doesn't mean that they can't use folic acid.

    5mg is a very large dose of folic acid and likely to be more than is really needed.

    What is your son's diet like and is there anyway of changing it to include more folate rich foods?

  • He was only on the 5 mg for about 3 weeks until his level had gone up, but I think with the monthly injections it has used it up. He has a fairly healthy diet. I have ordered Solgar folate 1000ug from amazon and will try him on that for a month, see if it makes a difference. Thank you for you reply

  • I am not a medically trained person but a natural way would be to encourage your son to eat more green leafy vegetables, sprouts, broccoli, asparagus, spinach - beans peas etc in his daily diet.

    Was his iron level measured at the same time as B12 and folate work together?

    Personally I have taken 1 – Folic Acid 400μg a day as a "maintenance dose" for more years than I can remember but I can still hear my mother's voice across the dinner table saying "Eat your greens Clive!". I too have B12 injections every month.

    Many breakfast cereals are now "fortified" with folic acid.

  • Hi clive, thanks for reply Yes his iron level was 242.4.

  • If you're a chemist like me then folic acid and folate are one and the same. But biologists are different and insist on calling a load of different chemicals 'folates'.

    The vast majority of people they can produce all of these different folates from folic acid and can get all they need from a proper diet, one that included plenty of leafy green veg, beans lentils, etc. Adding folic acid supplements in sensible amounts (400 to 800 ug a day) isn't going to do any harm. Folic acid is pretty cheap and easily available from any chemist, or most supermarkets.

    A small minority of people have a genetic defect in a particular enzyme that makes some of these different folates. This defect makes the enzyme less efficient, although it does still work. Some of those people may benefit from supplementing with methylfolate (also called Metfolin). This can be bought from Amazon.

    I would try folic acid from Tesco for a few months. If that doesn't help, try the same dose of methylfolate for the same time.

  • Decided to treat son's extreme tiredness (has injections monthly) with 5000 mg sublingual b12 and 1000 mg folate..(folate was at 6 when last bloods were taken) no great improvement on tiredness issue, but anxiety has returned with a vengeance. Now reading on line that too much folate and B12 can cause this. Don't know what to do now!

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