I’ve been having some tests done as a result of some symptoms I’ve been having. Heart palpitations shortness of breath, severe anxiety.
I have a hiatus hernia/acid reflux/IBS and have taken PPI’s for some time.
My test results have come back. Someone in the B12 deficient group on another site has said to supplement with folic acid for 2 months whilst keeping a symptoms diary as my folate has come back slightly low (albeit in range at the GP surgery) and she suggested that low folate May be masking an accurate reading of the B12.
I will attach my test results
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SpiritualT
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Your folate is fine. It is more than twice the lower limit. If this person told you to take 5,000 mcg of folic acid a day then they are giving you advice that may be harmful. Ignore them and leave that Facebook group.
Folate cannot possibly interfere with your B12 test results.
Your test results show no sign at all of a B12 deficiency, or a folate deficiency.
I’ve been on PPI’s. They suggested that the serum B12 test shows both the active and inactive B12 in your system and around 80% of that result is inactive.
A low folate level masks a B12 deficiency that’s why they suggested to up my folate. That it should be in the upper third of the range.
Yes, the serum test shows the active plus the inactive. Yes, about 80% of that is inactive. That is why the normal range for the serum test is five times higher than the range for the active test. Because that 4:1 ratio is accounted for.
Your folate is not low. It is more than twice the lower limit. Unlike the B12 test the folate test is both accurate and precise, and there is little overlap between 'normal' and 'deficient'. It does not need to near the top of the range. You do not need to take folate.
No, low folate does not mask a B12 deficiency. High folate can mask one symptom on a B12 deficiency (macrocytic anaemia). Nothing indicates that you have a B12 deficiency.
I suggest writing a symptoms list for neurologist which includes any neurological symptoms you have and it might be a good idea to take copies of your blood test results with you.
Do you recognise any of the symptoms in the lists below?
Perhaps you could ask GP to test you again in a couple of months time so that you can compare the two sets of results? GP is unlikely to agree as your results appear to all be within normal range.
Do you have any older blood test results from over the last year or so that you could compare with these results to see if anything has chnaged significantly?
It is possible to get these tests done privately in UK . Search "private blood tests uk".
There may also be private GPs in your area.
Have you had any thyroid tests? I suggest putting any thyroid results on Thyroid UK forum on HU.
Thanks for the detailed reply. Yes I’m in the U.K., the GP said my Vit D are within normal range.
I’ve had my thyroid tested it was fine.
Yes my serum B12 was 271 in September last year and I had an active B12 test which I Paid privately for in February of this year but I had been supplementing until a few days before and I know this gives skewed results.
There's a lot of B12 info in other thread I linked to at bottom of my first reply which I suggest you have a look at when you have time.
In a nutshell in UK, guidelines suggest if you have the symptoms of b12 deficiency, with other reasons for symptoms excluded, you should be treated even if serum B12 is within range.
Finding a GP/specialist who is fully aware of current UK guidelines/documents about B12 deficiency is another matter.....
Have a look at this flowchart below.
The right side of flowchart deals with patients who are symptomatic but have a serum B12 level that is within range.
Flowchart from BSH Cobalamin and Folate Guidelines
Someone in a B12 group has advised me to supplement folic acid for 2 months as mine is only 6.1 and then get retested. They said the low folic acid could be giving me a false reading of normal B12.
I’m not taking anything no B12 or folate. My folate is in range but still on the low side. Someone suggested it should be more like 15 and if this is the case, the folate reading could end up giving a false B12 reading. Increase the folate for 2 months, retest B12.
If your active B12 test gave high results (and I'll bet a pile that it did) then that means you do not have a B12 absorption problem. If the supplements raised it that much then you must be absorbing the B12 from those supplements.
In Sally M. Pacholok, R.N., B.S.N. and Jeffrey J. Stuart, D.O. authors of Could It Be B12 they suggest that levels should be over 500 for adequate health.
If you look on the following page of Pachalok's book you'll see that she says "'we advocate treating all patients who are symptomatic and have serum B12 levels under 450 pg/ml."
Yes if does say that. They say to treat the symptoms not just a serum blood results as serum blood results show both active and inactive B12 so a serum blood result isn’t a true account of what your actually using.
Yes, 80% of the B12 in the blood is not 'active' B12. No that doesn't matter because the people who designed the tests know this and they aren't stupid. That is why the normal range for the serum test is about 5 times higher than for the 'Active' B12 test.
It's like counting individual members in a flock of sheep. You can count heads, or you can count feet. Whichever way you do it, the number of sheep you'll get will be a good measure of how many sheep you have. Only an idiot would decry the foot-counting method because it gave too high a value.
Yes I was supplementing B12 before my active text so that will have skewed my results. You have to be off all B12 supplements for at least 4 months for a better reading.
ur bloods look great, u should see the state of mine lol. One thing u should remember though is b12 levels that one person may feel fine on another person may feel really unwell. Also the b12 is not always accurate so symptoms need to be considered. That’s if u can actually find a doctor that listens
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