B12 deficiency /PA and Folate levels ... - Pernicious Anaemi...

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B12 deficiency /PA and Folate levels and Folic Acid


I hope a quick Question

I Have PA, and 10 weekly injections (and autoimmune thyroiditis, Hashimotos diagnosed Dec 17)

folate levels found to have been low from blood tests back to Oct 16 when 7.6 (2.7-34) but was not treated

Folic acid was not added until Dec 17 when a Nov Blood test had showed a level of 6 (2.7-34) and was told to just take for 2 months (sorry by GP prescription so higher dose to over shelves but cannot remember actual dosage)

Bloods 2.2.18 - Folate level reported as > 20 (folic acid stopped)

Latest bloods 16.3.18 have shown it to have dropped again to 15.2 (2.7-34) so not low - mid range and not taking any folic acid meds

Is this a 'normal' sort drop to see following a short 2 month course of meds, or should the Folic Acid continue on a long term basis to maintain levels to help the B12 injections?

Any advice gratefully received

4 Replies
clivealiveForum Support

Hi MishB

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 works closely with vitamin B12 in making red blood cells and helps iron function properly in the body.

Personally I have taken 1 – Folic Acid 400μg tablet every day for more years than I can remember but then I have B12 injections (cyanocobamalin) evey three weeks due to having P.A. for 46 years.

I am not a medically trained person.


folate levels are much more responsive to food etc than B12 levels.

PA can affect your ability to absorb other vitamins and minerals - folate and iron are the common ones.

Suggest that you look at folate in diet - if it is already good then try regular supplementation with a suppermarket supplement - 400mcg a day or double that. The dose the GP will have prescribed is 5mg which is the dose appropriate to correcting the damage done by a deficiency but more than is needed for maintenance if you have an absorption problem.

MishB in reply to Gambit62

Thankyou Gambit for that info, i eat a lot of greens although draw the line at Brussel sprouts!

My GP actually called me last night following a letter i had dropped in a week ago re my still High TSH results (around 3 and not under 1)and had my levo increased again and i mentioned the dropping folate and she has prescribed me further high dosed folic acid and finally has agred after six months of feeling really unwell, referred me to an endocrinologist who a client of mine sees who has aninterest in PA/autoimmune thyroiditis..on the NHS, and has told me to stay on the folic until i see him, maybe might get some answers ......watch this space

Gambit62Administrator in reply to MishB

having PA will affect your ability to absorb levo - likely that you will need about 2x what the GP expects.

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