B12/folate

[Pastie121]

Hi everyone can any one please tell me. I've just had some results in for folate level 6.1........b12 288..coming back as normal does anyone know are they normal????

[fbirder]

The folate result is above the lower limit of normal and is unlikely to indicate a deficiency.

The B12 level may be just above the lower limit, or it may be way above the lower limit. It's impossible to say without knowing the units used and the range. The result will have been quoted as something like -

288 ng/L (250-800)

[Pastie121 in reply to fbirder]

Thankyou for quick response. It was only over the phone the result given..

[Pastie121 in reply to Pastie121]

The level was 55 before so it looks like it has gone up. But still been having a lot of problems. Only supplementing but have been doing one morning one night and feel a lot better.. I have rung back and they are telling me 288 unit pool/Leaders ref range. 115/1000.....folate 6.1 unit UG/L if that is any more info x

[fbirder in reply to Pastie121]

OK. The B12 is 288 pmol/L with the bottom of the normal range as 115 pmol/L. That is the bottom end that they use in Hull and East Yorkshire. Anybody below 115 is treated. They also consider anybody between 115 and 150 as being intermediate and they are also treated.

Were you taking a B12 supplement before those samples.

[Pastie121 in reply to fbirder]

Thankyou that great thanks for your time. Yeah only taking one maybe every other day.

[palmier in reply to Pastie121]

Serum values can normalise quickly after supplementation. I'm not sure that is because the deficiency is cured. Normally people get 6 loading doses (1000 mcg hydroxycobalamin injections) even though serum values probably are normalised after the first injection. So why continue with five more injections? Because a certain amount of b12 should be administered, regardless of what the serum value is after the first injection.

For the same reason it might be wise to continue supplementation.

According to this article serum values normalised within a few weeks on one 500 mcg tablet a day, even though they probably didn't absorb more than around 100 mcg a week. Compare that to a normal loading regime of six injections, which should add around 1800 mcg to the body! (30 % if each 1000 mcg hydroxycobalamin injection is retained.)

ncbi.nlm.nih.gov/pmc/articl...

I don't get it. Why do they think the deficiency is cured just because serum values are quickly normalised after a few weeks supplementation?

Why should anyone have injections if you just have to pop a pill for a few weeks? Why should anyone have six loading jabs if serum values normalise after one or perhaps two?

Is it not better estimate how much b12 has been added to the body (knowing how much is absorbed from tablets and retained after injections) than just testing the serum value during supplementation? Is it me or the doctors who don't understand?

Sorry for the maths!!!! If you're in UK, how come you didn't get injections?

[Pastie121 in reply to palmier]

I did get started on injection but only had four then dr. Thought I was allergic after a a really bad reaction which I now understand could have been the feeling worse before better,and told me to go get some supplements that was that..

[palmier in reply to Pastie121]

Ok, so you got most of the loading doses. How strong are the tablets you've been taking?

[Pastie121 in reply to palmier]

I agree with all your saying and t o be fair when I saw the neuro I thought she was shocked when I said I wasn't being treated. All she said was she would write to my dr. And she ordered me a brain Mri to rule out ms. I'm taking 500 capsules.

[fbirder in reply to palmier]

Serum values will not be normalised after one injection for people with a deficiency.

When you inject B12 is slowly leaks into your bloodstream over a few hours. Once it gets into the blood some of it will get stored (mainly in the liver) and some (the majority) will get flushed out by the kidneys. The liver can store a lot of B12, about 4 or five year's worth. So it takes many doses to get the liver's stores back up to where they should be.

Some people need injections because, for them, the pills don't work. Almost none of those studies 'proving' that oral B12 works as well as injections prove any such thing. Very few of them distinguish between a B12 deficiency and Pernicious Anaemia. So some of their subjects could easily have a dietary deficiency. None of them asked about their subjects use of PPIs or metformin - both of which can cause a B12 deficiency without totally blocking absorption.

The reason doctors rely on measuring amounts of B12, rather than calculating it from theory, is that measuring it is immensely more accurate. To know how much a person might have in their blood after a series of injections you would have to accurately know -

How fast the B12 passes from the injection site to the blood.

How efficient the kidneys are at removing the B12 from the blood (which varies depending on how much B12 is in the blood).

The rate at which B12 moves from the blood into the liver (which depends on the amount in the blood).

The rate at which the liver eliminates B12 in the bile.

The efficiency with which that B12 from the bile is reabsorbed.

The amount of B12 the person is eating.

The efficiency with which that B12 is absorbed.

Each of those will differ quite a bit from person to person. Each would be very difficult to measure.

[Pastie121 in reply to fbirder]

Thankyou for all your info

[Nackapan in reply to Pastie121]

Get them printed off. The range will normally be given in brackets on the right.

My folate was given in ng/ml

The range on blood form was 2-10ng/ml

I was told by Gp.cant go too high.?? I took 400mcg folic acid. Never had it before and went uo to above 24ng/ml!

So although having absorption problems with iron and b12. Obviously the amount of veg . Is absorbed. So everyone different in how their bodies absorb nutrients. It's trying to get the balance

Check on blood form anything else

Then you won't do what I did when I took supplements not really needed.

Takes a while working it all out.

[Pastie121 in reply to Nackapan]

Thankyou x