Vitamin B12 "normal" Folate low - Pernicious Anaemi...

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Vitamin B12 "normal" Folate low


Vitamin B12 is 365 (normal range 181-910), but my Serum Folate is 5.1 (should be >5.4). My Serum Ferratin was 28ug( (normal 10-291). What does this mean please, Is my B12 OK, and if so why is My Folate low? I want to know how best/what to supplement.

Someone mentioned on the Thyroid forum that I may need to supplement Iron. I have found this Vitamin B Complex

This complex has Vitamin C in it (is that enough Vit C to take - 160mg?)

Would I still need extra B12 and Iron? Better You do B12 spray, and also Iron spray, would the three (Vit B complex tablets, B12 spray, and Iron spray) be enough to take to get any benefit?

12 Replies
clivealiveForum Support

Hi clarabelle17

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


numbness and tingling in the feet and hands

muscle weakness


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 and these can be bought cheaply over the counter at your local pharmacy or supermarket.

Alternatively eat plenty of leafy green vegetables. sprouts, broccoli, asparagus, peas, beans, spinach etc as these are a natural source of Folate. Folic acid can also be found in many breakfast cereals nowadays.

Having thyroid problems may put you at an increased risk of a B12 deficiency and your level is in the lower half of the range so you may benefit from supplementing or eating more meat, fish, seafood, eggs, poultry and dairy produce.

I am not a medically trained person but I've had Pernicious Anaemia (one of many causes of B12 deficiency) for more than 46 years.

I wish you well.

QUE6T-33 in reply to clivealive

Hi Clarabelle, your taking daily Folic Acid, but do you also take B12 with that ? Can I ask which brand Folic Acid you found works for you ?

I always have high in range B12 & do not supplement, but the Folate Serem is within but low in range. Ferritin is high in range too. Just wondering if ok to supplement methylfolate on its own.

clivealiveForum Support in reply to QUE6T-33

Any supermarket of pharmacy's own brand Folic Acid 400μg tablet per day will be fine - either that or increase your diet of leafy green vegetables and fruit for natural sources.

QUE6T-33 in reply to clivealive

Thanks Clivealive, I'm ok with forms of Folic Acid intake, just asking whether ok to supplement methylfolate without supplementing B12 at same time.

fbirder in reply to QUE6T-33

If you have normal B12 then it is fine to take any form of folate. It is only a problem if you have low B12, when the folate can mask one particular symptom of a B12 deficiency.

Most people will find no advantage in taking methylfolate. It is just as effective as folic acid but substantially more expensive (methylfolate is about 13p per tablet; folic acid is about 1p per tablet - so methylfolate is about £43 a year more costly).

QUE6T-33 in reply to fbirder

Thanks for explaining to me - appreciated. What particular symptom of B12 deficiency are you referring to, so that I'm

aware please. Would you know how long you should stop

B12 Folate supplements before Serem testing ? Thanks

fbirder in reply to QUE6T-33

Taking folate supplements when also B12 deficient can stop macrocytic anaemia. That is the symptom that can be masked. Unfortunately a lot of doctors believe (wrongly) that anybody with low B12 must have macrocytic anaemia. So they could miss a B12 deficiency.

QUE6T-33 in reply to fbirder

Thank you for that


It is unlikely that you are B12 deficient with a result of 365, though the serum B12 test can be a bit difficult to interpret as the normal range is very wide so different people will be okay at different points within that range so no guarantee that 365 is the level that is right for you. If you have had a B12 test in the past then it would be useful to compare the two levels. If there was a significant drop (>20%) that would indicate that you have an absorption problem.

Generally your body uses stores to regulate B12 levels but if you have an absorption problem this doesn't work anymore so levels start to plummet.

Folate isn't stored in the body so levels are much more responsive to dietary intake. If your diet is rich in folate then the result would indicate that you have an absorption problem. As folate is absorbed in the ileum, which is where B12 is absorbed, a folate deficiency is generally associated with a B12 deficiency

As folate and B12 are used together in a number of processes in your cells, the symptoms of B12 and folate deficiency overlap considerably. They also overlap with the symptoms of other conditions, including thyroid problems. What are your symptoms.

An MMA test would help to clarify if there is both a B12 and a folate deficiency going on, but it is a more difficult test and generally needs to be done at a haematology department/in a hospital.

Did you have a full blood count done as well? any signs of macrocytosis? - red blood cells being larger and rounder than normal. This can be masked by iron deficient anaemias.

Ferritin is just one measure of iron and it would be useful to look at other iron measures to check if you have an iron deficiency before you start to supplement.

Macrocytosis is a very common symptom of B12 deficiency but isn't necessarily one of the first to manifest.

If you have hashimotos then there is a significant chance that you will go on to also develop PA - the most common cause of B12 absorption problems. - rate from studies varies between 10-40%.

Folate can mask a B12 deficiency. It's best to get the B's straightened out and also the iron tool At 60, you should not need much iron. A B-Complex can cause more harm than good so I would not advise it. 365 is a tiny bit low -- preferable 400-900. I know what the rules are and I also know what healthy people are. Try boosting your B12 some and see what happens. Cannot hurt and can only help. Be well~Pood

This group is extremely helpful.

Your B12 and iron look fine.

You can up your folate with supermarket folic acid tablets. 400 mcg a day should do it.

Is there anything that makes you think you may have a problem?

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