Pernicious Anaemia Society

Advise about B12 & Folate please! :-)

Hi Guys

I have recently been diagnosed with Hashimoto's disease and have discovered through the amazing advice of the members on Thyroid UK that I am severely deficient in vitamin D. I have now been prescribed a loading dose so this is getting sorted.

In terms of my vitamin B12/ferritin/folate levels, a few of the members were slightly concerned that my levels were on the low side even though my doctor said they were in range. I have been on a website that they sent me regarding symptoms of vitamin B12 deficiency and I have loads of the symptoms on there so they suggested that I come on here and get your advice. from what I have read, guidelines are different for different ages. I am 41 and please see below my results - any thoughts and advice whether I need a supplement would be much appreciated as I am trying to get my health much better again.

B12 452ng/L (211 - 911)

Ferritin 143 ug/L (10-291)

Folate 2.9ug/L (3-14.4)

Other results if needed:

Vit D 14.4 nmol/L (<30 indicates deficiancy)

Serum total bilirubin level 13 umol/L (<21)

Serum alkaline phosphatase level 87 iu/L (30-130)

Serum alanine aminotransferase level 128 (<40)

Serum calcium level 2.23 (2.2 - 2.6)

Serum albumin level 45 g/L (35-50)

Serum adjusted calcium concentration 2.13 mmol/L (2.2-2.6)

Serum inorganic phosphate level 0.82mmol/L (0.8-1.5)

Thanks in advance for your help! :-)

7 Replies
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Hi Kimmicustard you are Folate deficient.

"Folate

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. Folic acid is also being "fortified into" many breakfast cereals.

Folic acid is crucial for proper brain functioning and plays an important role in mental and emotional health. It helps in the production of DNA and RNA, the body's genetic material, especially when cells and tissues are growing rapidly, such as during infancy, adolescence, and pregnancy. Folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body. Vitamin B9 works with vitamins B6 and B12 and other nutrients in controlling the blood levels of the amino acid homocysteine.

Rich sources of folate include spinach, dark leafy greens, asparagus, turnip, beets, and mustard greens, Brussels sprouts,, soybeans, beef liver, brewer's yeast, root vegetables, whole grains, wheat germ, bulgur wheat, kidney beans, white beans, salmon, orange juice, avocado, and milk. ..."

(Vitamin B9 (Folic acid) University of Maryland Medical Centre).

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

I am not a medically trained person but I've had P.A. (a form of B12 deficiency) for more than 45 years.

I wish you well

Reply

Thanks for your help and kind wishes clivealive! :-)

I don't think they did my iron levels - maybe I should get those tested too? Can you advise how much folic acid I need to be taking please to raise my folate level?

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Personally I have taken 1 – Folic Acid 400μg tablet as a "maintenance dose" every day for more years than I can remember but if you can get to see a doctor please also ask him/her for their advice as I am not a medically trained person.

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OK - thanks clivealive! Hope you have a lovely day :-)

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Brilliant - thanks Eaoz! :-)

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Kimmicustard,

there is such an overlap of symptoms between B12/folate and thyroid. Unless you are absolutely sure that your thyroid medication is under control I would be wary, particularly given the B12 level above, being well into range (and iron levels also being good) about assuming that the symptoms you have are related to B12.

Your folate is on the lowside - as your iron and B12 are good I think the first thing to look at would be your diet - and making sure that you have a good variety of fruit and veg (though not too much by way of brassicas (cabbage family) as these contain something that can inhibit thyroid function. The best source of folate is dietary.

Whilst hashi's is associated with a high incidence of absorption problems, the first problem tends to be iron. Ferritin is quite a good indicator of iron status and your ferritin levels are actually quite good.

Your calcium levels look low but think they should pick up as the vitamin D deficiency is resolved.

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Hi Gambit62 - that's really helpful thank you. My medication is not yet under control so I think I will just see how I get on then as like you said, it could be the thyroid symptoms.

I will up my fruit and veg intake first and try that to raise the folate level.

Thanks again for your help. :-)

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