Results!!

[SpiritualT]

I’ve had my active form of B12 taken and Folate without supplementing and the folate has come back as abnormal. Apparently if I supplement folate and my B12 also rises then good news if not, then the low folate could be masking a B12 deficiency and means I have problems absorbing because I eat meat etc. Anyone have any information on this.

[fbirder]

Taking large amounts of folate (1000 mcg, or more, a day) can mask an undiagnosed deficiency if a deficiency is present.

Your Active B12 result strongly suggests that you do not have a deficiency, so taking folic acid will be OK.

[SpiritualT in reply to fbirder]

Why would I be deficient in folate though? When I’ve looked at the symptoms I’m suffering from heart palpitations which I’m under investigation with a cardiologist for and that is a symptom of low folate.

[fbirder in reply to SpiritualT]

The most common reason for being low in folate is not consuming enough in your diet.

[Sleepybunny]

Hi,

My understanding is that none of the tests used to help diagnose B12 deficiency eg serum B12, Active B12 (HoloTC), MMA and Homocysteine are infallible.

It is possible to have B12 deficiency with normal range test results.

Flowchart from BSH Cobalamin and Folate Guidelines (UK document)

stichtingb12tekort.nl/weten...

Flowchart outlines process for diagnosing PA and Antibody Negative PA in U

Bottom right of flowchart in link above indicates that doctors should consider continuing treatment in people who are symptomatic for B12 deficiency even if tests such as Active B12, MMA and Homocysteine are normal/negative.

Link about MMA mentions patients who were symptomatic with normal range MMA and Homocysteine.

Methylmalonic acid

stichtingb12tekort.nl/weten...

There was a recent post on forum which I'll try to find, about a Mayo Clinic article that suggested none of the current tests are totally reliable.

The article mentioned was a review of the problems of diagnosing B12 deficiency from Mayo Clinic Proceedings: Inn.Qual.Out. June 2019 Vol 3 (2) pp 200-214

I am not medically trained.

[Gambit62 Administrator]

folate is very responsive to dietary intake. B12 much less so.

folate found in fruit and vegetables - particularly green leafy veg.

if you have plenty of green leafy veg in your diet then that would suggest an absorption problem (though there may also be factors around other elements of the diet - eg coffee and tea can inhibit uptake of some foods - spinach, a good source of folate, inhibits uptake of iron etc as examples).

[JennaShi]

How long have you been off of your folate and b12 supplements?

I don’t know much about active b12 test other than it’s the usable form but i do know that you can be in range and still experience symptoms so it would be good to keep track of those and share them with your doctor.

[SpiritualT]

Yes I know. I haven’t been on any supplements. I’m going to start supplements and retest in 2 months