Folic acid with B12 injections?

[njames50]

My god-daughter started loading doses of B12 this week, and she has low folate (239: normal range 285-1475). She did not take a folic acid supplement after the first injection, but did after the second. She feels worse after the second injection than she did after the first. Should she be taking folic acid or not?

Her B12 level before starting the injections was 195 (insufficient below 250);

Iron 6.14 (normal range 6.60 - 26.00);

Transferrin saturation 10.06 (normal range 20.00 - 55.00)

Thanks for your advice.

[Gambit62 Administrator]

Starting folate after the second B12 loading shot would be about right. B12 and folate are used together for a number of key processes so correcting a B12 deficiency without correcting a folate deficiency isn't going to resolve anything.

Ideally B12 deficiency should be addressed first as there is a very very small risk of precipitating other neurological problems if folate is treated first. And this is what has happened.

It isn't uncommon for people to feel worse before they start to feel better as they recover from B12 deficiency - so it may just be that.

[njames50 in reply to Gambit62]

Thanks - that's very helpful and reassuring.