Low Folate and B12 injections - Pernicious Anaemi...

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Low Folate and B12 injections


Hi everyone, ok need to check with others more knowledgeable than me... if flagged as low in folate, you need to get the folate up before injecting B12 as it needs the folate to bind to to get to the cells.... is that correct? I have someone who's folate level is 3.8ug/L (3.90-19.80) , B12 Serum is 322, could be showing higher than normal as folate too low to uptake maybe? Person is also severly vit D deficient and is of course symptomatic and wants to start self-injections as Dr not treating as B12 'normal'. Help, she has asked for advice and others have told her to buy her own supplements as ones Dr gives are full of additives... I am concerned she can't buy it in large enough quantities, especially vit D really and that she has been told to inject straight away without addressing the low folate first. I may be wrong, please feel free to correct me..... want to give her good advice......

8 Replies

there is a small risk of initiating SACD and nerve damage if folate is treated before B12 - so start B12 24-48 hours before folate.

Galadriel1 in reply to Gambit62

Her B12 is 322 . I had been told that as she has low folate that needs to come up before B12 or it will just raise level falsely and not do anything. Can you clarify for me. I have got her to go to Dr. and request vit D and folic acid and he will not give her B12 as he says her level is normal and I don't think he's offered folate either or Vit D3 she was about to order them online and pay a fortune. Just want to give her the right advice.

fbirder in reply to Galadriel1

There's no need to pay a fortune for vitamin D or folic acid. Vitamin D costs about 3p per tablet from Tesco. Folic acid is about 1p.

No, folate has no influence at all on transfer of B12 into the cells. I suspect you've been misled by a misinterpretation of some recent survey results that showed that both folate and B12 were needed for best reduction of symptoms. Unfortunately somebody posted on Facebook that this was because folate is required for efficient uptake of B12. She was wrong.

Some people say that supplementing folate with low B12 can cause or exacerbate nerve damage. The evidence for this is minimal at best and possibly non-existent. And if it were the case this sort of nerve damage isn't going to happen over a couple of days.

Many supplements will be 'full of additives'. A grain of salt (table salt, not the posh pink stuff) weighs about 500ug. So a 10ug dose of Vitamin D would be almost invisible if they didn't add other stuff.

Could I also add that it is not safe behaviour to inject without medical supervision as there is a very slight risk of an adverse reaction. Really, could this person find another Dr who is willing to do a full work up and then you will have more information.

I have said exactly that and given her as much help as I can to go to the Dr. and ask for what she needs including a 'trial' of loading doses to see if it helps her symptoms. Also so her first injection is done by her surgery.



see this post on B12 and folate


Ok now not sure but her GP is not treating her for B12d he says her levels are normal (322) so he will not be too willing to give her B12, he will probably be happy to give her some folate if she asks as it is just below the lower limit 3.8 (3.90 - 19. ?) He will also have to treat her vit D and I imagine will put her symptoms down to that...... I think she needs to do it through Dr. but that means no B12d as she's not deficient in his eyes.

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