B12 and folate interaction

[jarlethblue]

Can I ask if it necessary to take Folate in the form of folic acid or Methylfolate to aid the absorption of B12 when on injections? thanks. J

[fbirder]

No.

With injections your body ‘absorbs’ all of the dose.

Folate doesn’t affect B12 absorption.

Folate works with B12 in one of the reaction mediated by B12. But taking more B12 doesn’t increase the body’s need for folate any more than a normal person needs.

Some of the conditions that affect B12 absorption can also affect folate absorption. To make sure you have enough 400 mcg of folic acid a day can’t hurt. Indeed, in the US, all women of childbearing potential are recommended to take that amount.

Some people (about 9%) have a mutation that decreases the efficiency at which they produce methylfolate. Most of them can easily compensate (they just make more of the enzyme that does the conversion). But some might benefit from taking methylfolate. Taking that instead of folic acid might help, but it is about 10 times more expensive.

[jarlethblue in reply to fbirder]

thanks so much....you are very good....it is just since I began recently taking Methylfolate my breathing had improved....I can take deep breaths whereas before it felt like air hunger and also suffered breathlessness. J

[deniseinmilden]

Having read through your last few posts...

I just wondered why you don't you want to use hydroxocobalamin as suggested? This is the B12 most suited and most effective in most people (and simple, safer, and cheaper), hence why it is used in the NHS in Britain?

2ml ampoules don't give you more B12 than 1ml ones - just more water. To work out the strength you need to look for the mg of active ingredient. Most people use 1mg in 1ml hydroxocobalamin. I use Pascoe brand ampoules that are stronger and are 1.5mg in 1ml. I haven't seen any 2mg ones and know that people who need 2mg per day do 2 injections to supply this.

I'm sorry I have no idea about postage to Ireland.

B12 is used in DNA synthesis, nerve function and energy release which use B12. There are many other vitamins and minerals that are needed to make these processes work properly, particularly folate.

As your body gets more B12 it can use up other things as it heals the damage caused by the deficiency and this can lead to a shortage and therefore deficiency symptoms of others.

Many people get good results from taking a broad spectrum multivitamin and mineral supplement plus extra folate, potassium, magnesium and iron.

You can Google these to find out the symptoms of deficiency and excess and what the best food sources are that you might like.

Most people should methylate without any problem but a few of us don't and need a methyl group from their supplements.

Because injectable methylcobalamin is unstable and expensive, etc, if you can't absorb enough B12 from methylcobalamin sublinguals it's easier to use hydroxocobalamin for your B12 plus methylfolate for your source of folate.

While I accept the science says we should only need a small amount of supplementary folate, it also says we shouldn't need lots of B12 so be aware that while the recommendation is for 400mcg of folate (B9), in practice lots of us who are injecting every other day or more frequently need about 10 times that at 4,000mcg = 4mg.

However please also be aware that too much methylfolate can give you a stonking headache!

If you decide to increase anything beyond the guidelines you do so at your own risk and should only make one small increase at any time and wait several days for it to take effect before making any other change. It is helpful to keep written notes of the effects of each incremental change. You should also try taking it out again at some point, just to check that it was what made the difference.

Good luck!

[jarlethblue in reply to deniseinmilden]

ah thanks so so much.....sadly I have had horrific reactions to methylcobalamin...terrfying anxiety, agitation and heart palps among other symptoms and have therefore stuck with cyanocobalamin. I was going to give the hydroxocobalamin a go as it gets good reviews.

And a big big thanks for explaining the strength of doses....I thought the 2ml would contain twice the amount which would save me injecting twice a day. your answer was so thoughtful and informative....hope your healing journey continues with great success. J

[jarlethblue in reply to deniseinmilden]

may I ask where you get your Pascoe from? thanks. J

[deniseinmilden in reply to jarlethblue]

You're welcome!

Versandapo.de

[Ryaan]

Only if you’re Folate deficient.

Feeling short of breath is one of the symptoms of low Folate.

If you’re low you should be given 5mg Folic Acid tablets otherwise you can take 400mcg which is daily recommendation.

Low Iron can also make you feel short of breath.

B12, Folate and Iron do work together.

[jarlethblue in reply to Ryaan]

thanks so so much....at my last blood test my folate was at 4......don't know the range......my doctor said it was acceptable....now I know it was not as the proof is in the pudding....I took Methylfolate and my breathing became a lot easier. thanks again as I was worried was not improving on the B12 injections so added the folate. J

[Ryaan in reply to jarlethblue]

Folate range is 3.10 - 20.00ug/L so you’re at the very bottom end at 4 so you should have been given Folate.

It should be 5mg tablets 1 daily to get your levels up.

The doctor looks at it as “within range” but it’s low. Actually I don’t think they look at it if it’s not flashing in red on their screens below the lowest range, (until you’re deficient) which is wrong.

[jarlethblue in reply to Ryaan]

thanks so much......i had never taken B12 supplements - ever - and when i began experiencing a host of physical problems had it tested and it showed 1,100mg and folate at 4....doctor told me i had buckets of it and that my folate was within range! I researched and began taking B12 and the clinical improvement has been fairly startling. And while i am a long way from better I think adding the folate will help as it has made a big difference to my breathing. thanks again. J

[Ryaan in reply to jarlethblue]

That’s ok, also check (Ferritin) Iron levels are ok as one of the symptoms is also shortness of breath if low.

Hope you feel better soon.

[jarlethblue in reply to Ryaan]

ah thanks....strangely Ferritin just above range...top is 150 and i at 151. again thanks for all the advice. J

[deniseinmilden in reply to Ryaan]

Thank you Ryaan for your really good, accurate and useful replies.

[fbirder in reply to Ryaan]

Unlike the B12 serum test the folate test is both accurate and precise. And the normal range is a much better representation of what to expect in most people.

So I wouldn’t be too worried about a serum folate that was above the bottom of the range. Definitely not enough to take 5000 mcg a day.

I would stick with 400 mcg a day as there is no urgency to boost levels quickly.

[jarlethblue in reply to fbirder]

thanks so much for informative reply....it so appreciated.....i was taking folic acid 400mgs and then 800mgs and did not find any effect from them. Then last two days have added 1,000mgs, morning and evening, of methylfolate and it has made a noticeable improvement in my breathing....for the first time in months i feel my breathing is easier, not caught and less laboured....I have got an MTHFR A1298C mutation and wonder is that why I feel the effect of the Methyl form. thanks again. Joanne

[deniseinmilden in reply to jarlethblue]

The science is wonderful but I and thousands of others wouldn't be here if we had followed it!

We are all unique beings with different problems and reasons for those problems.

Despite being a life long supporter of all things scientific, I am prepared to accept that there seems to be a gap in the scientific knowledge which means that if you follow the "one size fits all" science you may well suffer.

If you are prepared to take the risk then if you tailor your treatment to suit your needs then you can have a much better quality of life.

Symptoms are the only way that your body can tell you that it needs something. If you feel rough then you need to fix a problem. If you do or take something and you get better there's a good chance you needed it - whether the science says so or not.

Scientific "facts" only come about by observation. Just because maybe scientists have not yet listened to a situation and recorded it, it doesn't mean that it hasn't happened, it just means they haven't observed it and written about it yet!

[fbirder in reply to Ryaan]

Just for clarification...

B12 and folate do work together in one specific reaction, the conversion of homocysteine to methionine.

B12 and iron don’t work together. They are both required for the formation of red blood cells, but so are thousands of other biochemicals.

[deniseinmilden in reply to fbirder]

Please would you clarify things further by saying what you mean by "working together"...

I think I understand what Ryaan means, in common parlance, by working together and, as the processes that use B12 need other minerals and vitamins to happen (for example see the extended Krebb's), I would (using common parlance) understand that B12 DOES "work together with" iron, AND other inorganic molecules. I think maybe they work together in the creation of biochemicals?

It would be really good to hear what you mean by "working together" and therefore what you believe the term encompasses and what it doesn't.

[fbirder in reply to deniseinmilden]

An operating theatre nurse and a surgeon work together. An accountant for a health trust doesn't work together with a surgeon.

B12 and folate work together intimately. They take part in the same, single, chemical reaction. One reacts with the other.

B12 has a minor role to play in the Krebs Cycle, along with a few hundred other chemicals. To say that B12 works with any one of those chemicals is like saying that B12 works with carbon dioxide just because the two are remotely involved in the same process. B12 doesn't work together with most of those chemicals.

B12 is involved with the formation of, and methylation of, DNA. This is an essential part of absolutely every single part of the body's workings - including red cell production. Iron is also involved in red cell production. That is the limit of their relationship.

To say that they work together is as valid as saying that B12 works together with keratin as they are both required for toenail production. Or that B12 works together with iodine because they are both involved in the production of thyroid hormone.

When B12 is involved in every single bodily process it you can use a loose definition of 'works with' to say that it works with anything else ever found in the body. And if you then use 'works with' to justify increased consumption of something else...

B12 works with protein. So more B12 requires more protein.

Protein works with fats. So more B12 requires more protein, requires more fats.

Fats work with sodium. So more B12 requires more protein, requires more fats, requires more sodium.

Sodium works with potassium. So more B12 requires more protein, requires more fats, requires more sodium, requires more potassium.

Potassium works with B12. So more B12 requires more protein, requires more fats, requires more sodium, requires more potassium, requires more B12.

[deniseinmilden in reply to fbirder]

Thank you very much for a clear and well presented reply - definite "clarity". I knew it made sense and was the reasoning was there but I couldn't make my brain get a handle on it enough to explain it in simple terms.

So much of "me" has come back that I'm very grateful for what I've got... But there's a lot still not functioning like it did. I had to do a piece to camera on regional TV on Friday and it wasn't until I saw it, that it brought home how much of the neurological damage is still evident - even if though I can mostly get round it. However it's amazing that I could organise all the things I did so I'm grateful for that.