I'm new here - normal (?) B12 levels but low folate - help, I don't know what to think...

[gingermoo]

I'm new here - normal (?) B12 levels but low folate - help I'm TOTALLY confused....

Having felt absolutely awful for ages and suspecting a thyroid problem I elected to have the Thyroid Ultra Test offered by Medichecks. I've had a problem with low ferritin levels, diagnosed 10 years ago after the birth of my first child (incidentally my mother and son have exactly the same problem with ferritin). I was receiving iron transfusions but the last haematologist I was in contact with (usual one absent) refused to give me a another infusion stating my levels were "withing the normal range" and pointing out the lower cut-off level had recently been amended (reduced). I guessed what would happen (based on what happens every time supplementation is given either by infusion or tablets) - my ferritin levels go up following treatment then subsequently decline. My mother has been exactly the same for the past 48 years. My mother has been subjected to various investigations, including camera up both ends, to ascertain the reason but doctors have not been able to find any and GP states "just one of those things" YES, REALLY! My ferritin is currently low (see below).

The results are posted below (reference ranges in brackets):

TSH - 0.859 mIU/L (0.27 - 4.2)

Free T4 - 14.0 pmol/L (12.0 - 22.0)

Free T3 - 4.59 pmol/L (3.1 - 6.8)

Thyroglobulin antibody <10 IU/mL (0.00 -115.00)

Thyroid peroxidase antibodies < 9.0 IU/mL

Active B12 - 86.100 pmol/L (25.10 - 165.00)

* Folate (serum) 1.5 ug/L

* CRP High Sensitivity - 6.34mg/l (0.00 - 5.00)

* Ferritin - 11.4 ug/L (13.00 - 150.00)

Almost exactly a year ago I had my B12 levels checked with Blue Horizon after seeing a programme on television about B12 deficiency - these at the time were:

Active B12 - 64.0 pmol/L

MMA - 201 nmol/L (0 - 280)

Also - I'd previously had my homocysteine levels checked and these were elevated

So, in a nutshell, do I have anything to be concerned about? I assume there is no likelihood of a B12 deficiency as my B12/MMA levels appear to be normal (?) Do I just supplement with Folic Acid and assume my feeling awful must have to do with something else entirely...? I am a bit confused about about the varying reference ranges I have seen quoted and the differing units used to measure eg. pmol/L / nmolL / gmol/L - how do you compare (?)

Any advice/guidance you could offer me would be very much appreciated as I don't know where to go from here. Thanks

[Gambit62 Administrator]

symptoms of folate deficiency are more or less the same as those of B12 deficiency - homocysteine will be raised if folate is low.

Active B12 looks okay - so looks like you have a folate deficiency - assuming your diet is good in fresh fruit and veg that means an absorption problem.

Suggest you supplement folic acid and keep an eye on the B12 - looking for a sharp drop/downward trend over time which would show B12 absorption has also become a problem.

Absorption problems are very common with hypothyroidism - a number of ways this can happen including effects of hypothyroidism on transition through the gut. Iron is usually the first to show up as a problem. Speak to a pharmacist about taking an iron supplement if you can't speak to your doctor about it.

[gingermoo in reply to Gambit62]

Thanks for your reply - is there an optimal level of Folic Acid supplementation that's recommended?

[Gambit62 Administrator in reply to gingermoo]

400-800mg is the usual dosing - suggest taken with food - though the best source is food if at all possible

[gingermoo in reply to Gambit62]

thanks, I think I may have an absorption problem as diet not not bad... (i think!)

[Annkapp]

Sounds to me like you (and your mom and son) have a genetic problem breaking down and absorbing Folate. Folate, B12 and iron are all needed to prevent anemia. You can supplement with iron but may not get results if you are deficient in Folate/ B9. Also, you need Folate (and b12) to reduce homocysteine. You should have some genetic testing done or just try supplementing with active/ methylated B9 like 5-methyltetrahydrofolate instead of Folate or folic acid type B9. You may also need a large dose depending on your genetics.

Here is a link with info about Folate thyroid and genetics. http:/stopthethyroidmadness.com/m...

Another Link:

Dr. Ben Lynch’s MTHFR website

mthfr.net/

[gingermoo in reply to Annkapp]

Many, many thanks for your advice - will look into

[Annkapp]

Trying the first link again.

stopthethyroidmadness.com/m...