Low folate. Borderline B12. What woul... - Pernicious Anaemi...

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Low folate. Borderline B12. What would you do?

Mdolly•

6 years ago•4 Replies

Hey all...Some on advice on my results would be greatly appreciated. .

Serum B12 233 (197-771) ng/l

Serum folate 1.8 (2.99-26.) ug/l

Only other thing on bloods was my lymphocyte was slightly raised at 4.2 (1.00-4.00)

All other bloods were fine

My GP has prescribed folic acid supplements. .but should my B12 be supplemented too

I have long standing neurological issues.

Many thanks in advance for your time..

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clivealiveForum Support6 years ago

Hi Mdolly

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.

What sort of diet do you have? We source B12 naturally by eating red meats, fish, seafood, eggs, poultry and dairy produce and as long as you don;t have an absorption problem or are on medication that have an adverse effect on B12 such as antacids or PPIs, other autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) Type 1 diabetes, etc you should get enough from food.

However as your doctor appears reluctant to treat by our low/normal B12 level you will do yourself no harm by taking a supplement.

I am not a medically trained person but I've had Pernicious Anemia (a form of B12 deficiency) for more than 46 years.

I wish you well.

fbirder6 years ago

Ask your doctor to follow these NHS guidelines...

hey.nhs.uk/wp/wp-content/up...

Being borderline, with symptoms, your doctor should start you in a course of B12 and give you a test for Intrinsic Factor antibodies. If the test is positive, or the injections improve your symptoms then you have injections for life.

Sleepybunny6 years ago

Hi,

Some b12 info that may be of use below.

In UK, patients with B12 deficiency with neuro symptoms are supposed to get more intensive B12 treatment. See UK B12 documents for more info on UK B12 treatment.

B12 Deficiency Symptoms

pernicious-anaemia-society....

b12deficiency.info/signs-an...

b12d.org/admin/healthcheck/... (may need to be B12d.org member)

Risk Factors for PA and B12 Deficiency

pernicious-anaemia-society....

b12deficiency.info/what-are...

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

Have you been tested for PA? Coeliac disease? H Pylori infection?

Coeliac Disease

In UK, two first line tests are recommended.

1) tTG IgA

2) Total IgA

My experience is that Total IgA test is not always done but I think it's an important test as people with IgA deficiency will need different tests for Coeliac disease.

NICE guidelines Coeliac Disease (2015 version) recommend that patients with unexplained b12, folate, iron deficiencies should be tested for Coeliac disease.

nice.org.uk/guidance/ng20/c...

Coeliac Blood tests

coeliac.org.uk/coeliac-dise...

H Pylori infection

patient.info/health/dyspeps...

Any surgery involving nitrous oxide?

Nitrous Oxide

gov.uk/drug-safety-update/n...

UK B12 documents

BSH Cobalamin and Folate Guidelines

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

Flowchart from BSH Cobalamin and Folate Guidelines