Folic Acid if doing SI

I'm reading that if you want to SI frequently you need to take folic acid at a high dose.

Is it necessary to take 5mg daily if you choose to inject every other day.

I have some reservations about extra folic acid as I'm already above range and my symptoms worsened a lot (pretty much began apart from fatigue) after using multi vitamins with folic acid last year.

I know it's a very loose connection but it's something I'm battling with.

17 Replies

  • Hi Steap, I have just read Mike Newman's book Vitamin B12 deficiency and chronic illness. There is a chapter in it basically saying that some people feel worse taking the synthetic form of folate ie folic acid, and doses are much too high. He suggests a good source of 'greens' is much better for you, eaten raw too helped him, he does reference it : Nutr Rev.2007 Johnson. Sorry not 'au fait' with links! 😨

  • BTW I think it's an excellent book. It opened my eyes, anyway.

  • The reference -

    doesn't seem to mention any problems with folic acid vs folate. It does mention the masking of macrocytic anaemia if low B12 isn't treated.

  • Sorry I seem to have copied down the wrong source, I'm out now so will have a look later, brain not in gear today!

  • Sorry I was only on my mobile before, you got the right link, thanks, the reference was to "one recent study indicates that high serum folate levels during vitamin B12 deficiency exacerbate (rather than mask) anaemia and worsen cognitive symptoms" the eating greens, was as I said 'suggested' by the author.

  • Yup. But only when B12 levels are low as well.

    A response to that paper suggests that this is the 'folate-trap' in action where. Low B12 causes high folate.

  • Book doesn't arrive until tomorrow.

    The only people who may benefit from taking methylfolate (the so-called 'natural' form) are those with a malfunctioning methylenetetrahydrofolate reductase enzyme.

  • I was able to download a copy today, as I say, I will recheck the source later.

  • It's MTHFR, not just implying that I am lying (you could download the book on Monday) also trying to blind us with science!

  • I would of thought the 'so called natural form' would be better if you weren't actually deficient in it or felt 'my symptoms worsened a lot' as Steap said. Just a thought.

  • Well, the book arrived and I must say I am far from impressed. For a start, there is no index, no page numbers on the contents and no chapter titles on the page headings. So trying to find anything means flipping through the book.

    I went straight to the section on folate and realised that the author doesn't understand chemistry. He says 'the terms folate and folic acid are used interchangeably despite their differences'.

    There is, if you are a chemist, no real difference between folic acid and folate. When you dissolve folic acid in water some of it ionises to form folate. When you put folate into an acidic environment (like the stomach) most of it forms the acid.

    He then says that folic acid 'is not metabolized in the same way that the naturally occurring form of the vitamin is'. Folic acid is reduced in the body by the enzyme DHFR (dihydrofolate reductase) to form dihydrofolate. This, in turn, is reduced to tetrahydrofolate - by DHFR. Not only is folic acid metabolised in the same way as the 'natural' form but it is metabolised by the same enzyme!

    The next dozen pages are taken up with some rambling stuff about the fact that some doctors recommend 5mg doses of folic acid for people showing a folate deficiency. No mention of the fact that this should be a temporary fix.

    I couldn't believe that there was no mention of the folate trap, whereby a shortage of B12 can result in high blood levels of folate. As Eaoz mentions above, this is mentioned in one comment on the only scientific paper referenced in this section.

    I don't think I'll bother reading the rest of the book as I can't stand the rambling style.

  • fbirder, I understood it is recommended to take a low dose "ordinary" supermarket brand of Folic acid whilst injecting B12. How long is it safe to take the folic acid supplement if one is injecting B12 every 2 days? I am taking it every day since I began the B12 regime. Should I carry on taking it for as long as I inject B12? When I asked the GP she said "No need"... but having read many posts I decided otherwise. Saw GP today and I mentioned I was taking low dose Folic acid to help the B12 work...and she totally agreed! even saying it will also help with the Iron Fulmarate she prescribed today, following the gastro's recommendation (only one tablet/day).

    Sorry for hijacking the link...

  • The NHS recommend taking at least 200 ug a day, preferably by eating a balanced diet. Unless, you are pregnant, or might become pregnant, in which case they recommend 400 ug a day.

    Personally, I can find no reason why one shouldn't take 400 ug a day regardless. Especially if you know that you don't have low levels of B12 in your blood.

    A small minority might benefit from supplementing with methyl folate instead of folic acid (if you are homozygous for the C677>T MTHFR mutation). It might be worth trying 400 ug a day for a month to see if you feel better with it. It can't do any harm apart from being more expensive.

  • Thank you. Am taking 400 ug/day... so will carry on.

  • I can't see any point in taking extra folic acid if you are "already above range".

  • In a round about way, that is what I meant to say.☺

  • Hello Steap, I also self inject b12 every other day. My folate was at 6 last June it is now 12. I have lifted my folate by eating lots of leafy green vegetables, also squeeze lemon juice over them to maximise iron absorption. Every few weeks I have a multivitamin which includes 400mg folate. I understand it is much better to get folate from your diet. I hope this is helpful.

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