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There is a complex interaction between folic acid, vitamin B12 and iron. A deficiency of one may be "masked" by excess of another.

lucylocks profile image
13 Replies

After reading the above in a reply to a recent post, it has prompted me to ask if supplementing with too much B12 could make my folate low and ferritin high.

I had been supplementing with 2500mcg B12 and 200mcg folate, but do not take iron

Active B12 level when tested was top of range (although serum B12 was 385)

but folate was lowish at 6.94 (bottom of range 2.9)

Ferritin was 20 points over top of range.

I reduced my B12 supplement and ferritin is now mid range but Doctor would not test B12 or folate.

So my questions is could too much B12 cause a high ferritin level and a low folate level.

Thank you.

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lucylocks
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13 Replies

I dont know but this is helpful information so thanks for posting.

deniseinmilden profile image
deniseinmilden

Hi!

No, while they work together in the functions of the body they cannot "make" each other do things. B12 won't make your ferritin high or your folate low.

I'll try to explain...

If you think of vitamins and minerals as parts for building toy houses... to build a house (make the cells in your body work) you need bricks and windows and doors and tiles and gutters and all sorts of things (all sorts of vitamins and minerals). To be able to complete a house you need to make sure all of these things are available.

As you build each house you use up a certain number of bricks and windows and doors (your vitamins and minerals). Some things get used up more quickly than others - you need more windows for each complete house than you do front doors, for instance.

If you have an unlimited supply of all of the parts you can build house after house without any trouble.

But if you run out of windows you can't complete any more houses until you get some more. Just because you have run out of windows (say your vitamin B9 or "folate") and have lots of bricks (your B12) still available, it doesn't mean that you suddenly get more gutters (your ferritin).

The only way you can get more of the parts (vitamins and minerals) is to buy some more (absorb more from your food or from supplements). If you find you are getting a stockpile of gutters (ferratin) it might be because you have forgotten to put them on some of your houses (the mechanism for using up ferratin in your body isn't working properly) or someone has delivered more without you noticing (some of foods you ate had more in than you thought).

There is a condition called hemochromatosis where by your body doesn't work properly and your levels of iron or "ferratin" can build up so it is important to discuss your results with your Dr but as they have fallen again it may just be a reflection of a change in what you have eaten.

I have worked for a company that lab tests samples and have sent in doubles of the same sample but got different figures back for the same thing so don't get too hung up on the figures from lab tests - they are a good guide for flagging up something that is extreme but they are only a snap shot of what is roughly happening at the moment they were taken. Think about a blood test for alcohol - very high if you have just had a glass of wine but nothing the next day! The B12 tests are notoriously unreliable, especially once you have taken any supplements.

You need to see how you are feeling and it is a good idea to keep a symptom diary and compare that to your food and supplements intake.

lucylocks profile image
lucylocks in reply todeniseinmilden

Many thanks for replying and explaining in an easy to understand way.

Your reply is very much appreciated.

Thanks again and best wishes.

deniseinmilden profile image
deniseinmilden in reply tolucylocks

Thank you for your kind reply - I was wondering if I was being a bit too wacky but hoped it would help! x

lucylocks profile image
lucylocks in reply todeniseinmilden

No not wacky at all, it is a lot easier to understand than all the scientific terms.

Thank you.

Foggyme profile image
FoggymeAdministrator in reply todeniseinmilden

Love the house building analogy deniseinmilden . Just perfect...😉😀😀.

deniseinmilden profile image
deniseinmilden in reply toFoggyme

Thank you! It's so good to have some of my imagination back and to be able to think slightly beyond the basic facts again - cheers to B12... And supporting supplements!! 😁 😁

Foggyme profile image
FoggymeAdministrator in reply todeniseinmilden

Yay to that 😀😀😀

Gambit62 profile image
Gambit62Administrator

supplementing B12 and folate should not affect iron levels

folate is much more responsive to dietary intake and blood tests are much more accurate in determining folate levels than the serum B12 test is.

concerns about masking caused by folate supplementation generally relate to the possibility of delaying/masking macrocytosis - a type of anaemia caused by both folate and B12 deficiency in which red blood cells are rounder and larger than normal and is frequently used as a marker for B12 deficiency - other symptoms will be present and macrocytosis isn't necessarily one of the first symptoms of B12 deficiency to manifest - possibly far from it given the length of time that it takes for a full blown B12 deficiency to manifest. So, concerns are more around the implications for testing and use of markers that are established to require interpretation in the context of symptoms. Its more to do with the lack of knowledge of the people using the test results than it is to do with the supplementation

one caveat: if B12 and folate deficient recommendation is to start B12 before folate (24-48 hours) due to the very small risk of precipitating permanent nerve damage if the B12 deficiency isn't treated first.

lucylocks profile image
lucylocks in reply toGambit62

Many thanks for your reply.

Do you think I need to supplement with B12, as looking back on previous tests I find that when I stop the B12 supplement my levels tend to drop. Also should I supplement with the folate as level is quite low.

I understand we should go by symptoms and not just levels but as I am hypothyroid a lot of symptoms over lap, so I really want to cover all possibilities.

Many thanks.

Gambit62 profile image
Gambit62Administrator in reply tolucylocks

if you start to feel worse when you stop supplementing then definitely continue

fbirder profile image
fbirder

If you suffer from a deficiency of both folate and B12 then supplementing with folate can mask some of the symptoms of the B12 deficiency (macrocytic anaemia). That can lead to the B12 deficiency being untreated (but only if the doctor assumes that macrocytic anaemia must be present in a B12 deficiency).

Supplementing with B12 doesn’t mask the folate deficiency.

Here’s no such thing as ‘too much’ B12. If you stick in more than your body can handle then it soon goes out in the pee. It’s like a car with an oil leak. You need to regularly top up the oil to make the car work properly. But if you overfill the oil, so that it all leaks out the top, it’s not going to mean that your car needs more petrol.

lucylocks profile image
lucylocks

Many thanks for your reply.

It is very much appreciated.

Best wishes.

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