Folic acid query.

[Brownie49]

Hello, I have PA and have 3 monthly B12 injections, I'm always low in Vit D and Folate which my doctor tells me is in the normal range and nothing to worry about just take over the counter vitamins, the ranges all sit at the very bottom. However, the insert inside the folic acid says you shouldn't folic if you have PA caused by b12. I've spoken to the doctor who has never heard of this, who do I believe the doctor or the medical advice slip. I also have hypothyroidism for which I take NDT. Can I ask what other people take for low folate?

[fbirder]

The warning about folic acid and B12 deficiency isn't correct.

There are two problems with taking folic acid when deficient in B12. The first is that folic acid supplements can fix one symptom of a B12 deficiency - macrocytic anaemia. This is only a problem if the B12 deficiency has not been diagnosed and if you have a doctor who believes that macrocytic anaemia is essential if they are to diagnose a B12 deficiency.

The other problem is that a lot of folate, in the absence of sufficient B12, can exacerbate the neurological symptoms of the B12 deficiency.

Obviously, if you have been diagnosed with a B12 deficiency and it is being treated then these two worries are irrelevant.

If you have Pernicious Anaemia then, as well as the inability to absorb B12, you will have impaired absorption of folate, iron and Vitamin D.

It is recommended that all women of childbearing potential should take 400 mcg of folic acid a day. I can think of no reason why anybody should not take the same - especially if they may have PA.

b12science.com/B12Science/D...

[Brownie49 in reply to fbirder]

Thank you, I've visited a kineologist who picked by a have a defected gene that stops me from absorbing Folate I think she said something like mfthr gene. I take Vit d with K2 spray as I thought I may have a absorbtion issue. Doctors will not test for mthfr issue and said taking normal folic acid will be ok.

[fbirder in reply to Brownie49]

Sack the kineologist.

The MTHFR gene has nothing at all to do with folate absorption. And almost everybody in the world has at least one mutation in that gene. This is what one of the largest genetic testing companies in the world says about MTHFR - blog.23andme.com/health-tra...

Based on the existing data, scientists at 23andMe have concluded that people should not interpret their genotypes at the common MTHFR variants as having an effect on their health.

About 10% of people (including me) have a particular mutation (homozygous for C677T) that means that the may benefit from taking methylfolate, instead of folic acid.

[Brownie49 in reply to fbirder]

I have already, I felt she was feeding off me for information, she prescribed in Phosphatidylchorine to help with NAFLD and to help lose weight, so far can't see it working. I've read about methyl folate being a natural form but doctors won't prescribe as to expensive. Thanks for all the info and links, a very interesting read.

[fbirder in reply to Brownie49]

Yes, methylfolate is a natural form. There are several natural forms of folate, all of which need to be converted to the others

[Yogijo]

The high strength folic acid supplements I was prescribed have the same warning on the patient information leaflet. They say not to take if you have untreated B12 deficiency and also not to take if you have B12 deficiency caused by Pernicious Anaemia. I don’t have a diagnosis of PA because the IFAB test came back negative. However, since the test is unreliable I could have PA. At the moment I’m just taking them but planned to ask doctor about it.

[fbirder in reply to Yogijo]

The leaflet should say -

Do not take Folic Acid tablets and tell your

doctor if you have:

• an allergy (hypersensitivity) to folic acid or any of

the other ingredients in the tablets (see section 6)

• an untreated vitamin B12 deficiency such as in

certain anaemias and lifelong vegetarians

• pernicious anaemia (a form of anaemia caused

by lack of vitamin B12 ) or another condition caused

by vitamin B12 deficiency

• a malignant (cancerous) disease

If your doctor has prescribed them, and your doctor knows you have (or may have) PA, then that should be the same as telling to doctor.

If in doubt - ask your pharmacist.

[Yogijo in reply to fbirder]

I think it’s worth checking because you can’t always rely on doctor’s knowledge. In addition to folic acid I was also prescribed high strength vitamin D for deficiency and the patient information leaflet says to talk to GP if you have sarcoidosis (which I do) because taking vitamin D can cause high calcium levels with this condition. I contacted GP surgery for advice and the receptionist rang me later in the day to say the doctor not to take the vitamin D at this point and wait for them to get back in touch because they would need to monitor calcium levels too.