Pernicious Anaemia Society

Do I need to take folic acid?

Hi there,

I've seen a lot of people say that your folate level should be in the top third of the range while getting B12 injections. Mine, before injections, was 7.0 ng/ml (3.4 - 10.4) which seems right in the middle, so can anyone tell me, should I take folic acid?

I'm also on ferrous fumarate because my serum ferritin was only 13 ng/mL (13- 300), and I'm on every other day hydroxocobalamin since last Tuesday.

6 Replies

Taking B12 doesn't increase the body's folate requirements over and above those of normal people.

If I need to put more oil in my car because of a leak it doesn't follow that I need to put in more petrol.

However, there is no harm in taking folic acid in sensible amounts. So taking 400 ug of folic acid each day can't harm. And it will cost about 1p per day if you get it from the supermarket.


Ah okay thanks Eaoz I didn't realise - partly because I'd seen several comments like this one from Foggyme in response to someone else's query which seemed to suggest that B12 does affect folate levels:

"The aim is to have folate levels that are in the top third of the reference range.

Bumping along the bortom of the reference range is not good enough, particularly for someone with B12 deficiency.

As you're on injections every other day, your body will use up folate pretty quickly."


Hi ktwing. The reply in the link above is nearly two years old (pre-administrator and less well read days)...and I would no longer give advice about folate being used up quickly when on every other day injections - nor that folate needs to be at the top third of the reference range.

However, I would still say that bumping along the bottom of the reference range is not good enough for some people. In those cases, 400mcg folic acid as a maintenance dose would help.


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Ok thanks - I probably don't need to bother then for now. That's what I get for typing things into the search box - old advice ;) It's just all quite confusing for a newbie!

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Yes...know what you mean...and as research evolves, thinking changes too 🙄😉.

Folate does look okay but a good idea to get if checked periodically just to ensure that it’s being maintained...especially important if you're taking any drugs that impede the absorption of folate (surprising how many do - and GP's are not always aware).

Good idea to check the symptoms of folate deficiency and keep a side-ways eye out for them,just in case (new symptoms could equal low folate)

Good luck 👍


Of course, the best way to keep folate levels up is to eat lots of food that contains it. Green leafy veg, pulses, nuts and seeds are all excellent.


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