B12/folate

[maddie111]

What do I do about results please thank you

Vitamin B12 203 (180 - 900)

Folate 1.9 (4.6 - 18.7)

[clivealive Forum Support]

Hi maddie111 has your doctor not suggested you eat lots of leafy green vegetables or supplement with folic acid?

There is a complex interaction between folic acid, vitamin B12 and iron. A deficiency of one may be "masked" by excess of another so the three must always be in balance.

Symptoms of a folate deficiency can include:

symptoms related to anaemia

reduced sense of taste

diarrhoea

numbness and tingling in the feet and hands

muscle weakness

depression

Folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body and your B12 levels are "bumping along the bottom of the range.

Do you have any of the above symptoms?

[maddie111 in reply to clivealive]

Thanks for reply doctor has not suggested I eat leafy freen veg or supplement with folic acid. I have all of the above symptoms and I plan to speak to GP later this afternoon about what she intends to do.

[clivealive Forum Support in reply to maddie111]

Hopefully your doctor will "address" both you low B12 and your Folate deficiency as the symptoms B12 deficiency tend to develop slowly and may not be recognised immediately. As the condition worsens, common symptoms include:

Weakness and fatigue

Light-headedness and dizziness

Palpitations and rapid heartbeat

Shortness of breath

A sore tongue that has a red, beefy appearance

Nausea or poor appetite

Weight loss

Diarrhoea

Yellowish tinge to the skin and eyes

If low levels of B12 remain for a long time, the condition also can lead to irreversible damage to nerve cells, which can cause the following symptoms:

Numbness and tingling in the hands and feet

Difficulty walking

Muscle weakness

Irritability

Memory loss

Dementia

Depression

Psychosis

I hope the appointment goes well for you and wish you well. Let us know how you get on.

[Sleepybunny]

Hi,

You might find some of the links below useful. Some info is UK specific and may not apply if you're in another country.

My experience is that B12 deficiency and folate deficiency are not as well understood by doctors as it could be, so I think it's important to do some homework.

Are you symptomatic for B12 Deficiency?

Symptoms lists

pernicious-anaemia-society.... see Checklist PDF on right of page. I ticked all my symptoms and gave a copy to GPs.

b12deficiency.info/signs-an...

b12d.org/admin/healthcheck/...

Risk Factors for PA and B12 Deficiency

pernicious-anaemia-society....

b12deficiency.info/what-are...

b12deficiency.info/who-is-a...

B12 books

"What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper

Martyn Hooper is the chair of PAS (Pernicious Anaemia Society). Book is up to date with UK B12 guidelines. I gave a copy to my GPs.

"Living with Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper

Has several case studies.

"Could it Be B12; An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (USA authors)

Very comprehensive book about B12 deficiency with lots of case studies.

B12 blogs

Martyn Hooper's blog about PA

martynhooper.com/

Also an interesting blog about b12 issues on "B12 Deficiency Info" website.

b12deficiency.info/

PAS (Pernicious Anaemia Society)

If you suspect PA is a possibility, it may be worth joining PAS.

pernicious-anaemia-society....

PAS tel no [phone] answerphone

They can offer support and info to PAS members. In some cases PAS may be able to intervene on behalf of PAS members. PAS membership costs £20 for a year.

UK B12 articles

1) BMJ B12 article

bmj.com/content/349/bmj.g5226

2) BSH Cobalamin and Folate Guidelines

b-s-h.org.uk/guidelines/gui...

I gave a copy of this to my GPs.

Flowchart from BSH Cobalamin and Folate Guidelines

stichtingb12tekort.nl/weten...

Flowchart outlines when PA (Pernicious Anaemia) or Antibody Negative PA can be diagnosed in UK.

Flowchart makes it clear that in UK, people who are symptomatic for B12 deficiency should have an Intrinsic Factor Antibody test and start initial B12 treatment, this applies whether B12 is low or within range.

IFA test can help to diagnose PA but test is not always reliable and it is still possible to have PA even if IFA test result is negative.

Have you had an Intrinsic Factor Antibody test?

There is a useful summary of mainly UK B12 documents in the third pinned post on this forum.

Links about blood tests

You mention B12 and folate. Have you had ferritin and full blood count (FBC)tests?

b12deficiency.info/what-to-...

b12deficiency.info/b12-test...

patient.info/doctor/macrocy...

labtestsonline.org.uk/under...

patient.info/doctor/folate-...

I read that if a person is being treated for folate deficiency, it's very important to treat any co-existing B12 deficiency. See Management section in link above about folate deficiency.

Unhappy with treatment?

Link about writing letters to GPs about b12 deficiency.

Point 1 is about under treatment of B12 deficiency with neuro symptoms.

Point 5 is about being symptomatic for B12 deficiency with an in range result

b12deficiency.info/b12-writ...

CAB NHS complaints

citizensadvice.org.uk/health/

HDA patient care trust

hdapatientcaretrust.com/

UK charity that offers free second opinions on medical diagnoses and medical treatment.

Access to medical records (England)

nhs.uk/NHSEngland/thenhs/re...

england.nhs.uk/contact-us/p...

nhs.uk/chq/Pages/2635.aspx?...

I always get copies of every blood test. I learnt to after being told everything was normal and then finding abnormal and borderline results on the copies.

I am not medically trained.

[maddie111 in reply to Sleepybunny]

Thanks I am in UK and I am symptomatic

[KimberinUS]

Making sure they check your iron/ferritin level also as it is also needed to feel bettet. Additionalky if your iron/ferritin levels are currently okay make sure that they check these again in another month or two because it can get used up quickly once your body starts making new healthy red blood cells.