Folate deficient

[Arabella33]

I recently tested for deficient folate. 3.08 (3.89-19.45) I have terrible brain fog my b12 tested optimal. What does this mean and what treatment should I take ? Thank you

[Nackapan]

I would get a copy of your blood results. The range will be on the form. Some can get their results online too.

I assume your doctor will prescribe folic acid. And then retest your level. Whenuo tou can be on a maintenance dose which is usually 400mcg folic acid. If b12 levels ate optimal you may not need b12 treatment.

B12 is always tested and if necessary treated before folate. Tour doctor should have explained

[Arabella33 in reply to Nackapan]

Range ? Do y mean for B12? It’s >150 (37.5-187.5) so I think it’s ok. I hadn’t supplanted for 6 months prior.

My doc just prescribed me methyl folate 1000mcg but I bought 5000mcg strength.

Are my symptoms common and how long do they take to go?

I’m also taking 2000mcg adeno hydroxy b12 capsules

12000mch methyl b12 sublingual

Thank you

[Nackapan in reply to Arabella33]

I would only take what was prescribed as too much not a good thing . Only my opinion. Once folate levels have raised you can drop to a maintenance dose

Hope the hydrox sublinguals work for you let us know.

Symptoms vary but sound familiar. and no time frame is possible to give for them to go. I find some revisit. Some reduced some less severe some go. Bit like before diagnosis it is gradual for mr.

Hooe you get s quicker response.

[Arabella33 in reply to Nackapan]

I’m very deficient so I’m taking the large does for two months. Then I will retest

Doesn’t look like I’m deficient in b12 but I’m taking the extra just in case.

Thank you I hope they improve quickly also

[fbirder in reply to Arabella33]

Your B12 is too high to measure (the '>' symbol means 'bigger than') so there's no need to take such massive doses (no harm either, except to your wallet). I'm confused about what B12 supplements you're taking. You say you're taking 2,000 mcg a day of adenosylcobalamin, plus 12,000 mcg a day of methylcobalamin. But that you haven't supplemented for 6 months.

Such high doses are pointless as you can only absorb about 10 mcg from a single dose, so 11,990 mcg of your methylcobalamin are passing straight through you. I would finish off those tablets (they won't do any harm) and then swap to the cheapest tablets you can find that contain at least 5 mcg of B12, they type of B12 (methyl, cyano, or adenosyl, is irrelevant).

Throw away the 5,000 mcg methylfolate, those sorts of doses are OK for initial treatment of somebody with a severe deficiency but they may be harmful. Stick with the ones prescribed by the doctor, then switch to 400 mcg a day.

[Arabella33 in reply to fbirder]

When I took the b12 test I had not supplemented at all. Maybe it’s pooling as my folate is low?

I have just stated taking the methyl folate 5000mcg, 2000mcg adeno hydroxy b12 and 1200mcg sublingual methyl b12. I’m worried it won’t absorb.

I have severe deficiency for folate which is why I’m taking the strong tablets.

What are symptoms and how long will they take to go?

What’s the best way of supplementing b12?

Thanks

[fbirder in reply to Arabella33]

No, low folate cannot make your B12 'pool'.

If you had been supplementing with high dose B12 and stopped 6 months before the blood test then, assuming no absorption problem, you would still have huge amounts of B12 in your body. That would explain why your B12 is unmeasurably high.

Your folate is 3.08. That is not far below the low end of the range (3.89). It is not a 'severe' deficiency. Your doctor's prescription should be more than enough. ncbi.nlm.nih.gov/pmc/articl...

[Nackapan]

Depends what optimal is?

[Gambit62 Administrator]

Arabella - the term 'optimal' is often bandied about as being an ideal that people should aim for - however there is no such thing as we are all different and what may be optimal for one person isn't optimal for another. For me the use of the word is a red flag indicating that I'm not getting the best advice that I could if I see it on a site.

The B12 result quoted doesn't make sense as it gives a range but the use of > indicates that your actual result is above the measurable range which should be a higher level than the top of the normal range, but in the results you have given that isn't the case.

Folate deficiency comes on quickly and should reverse quite quickly though it does depend on what is actually causing the symptoms. If you have macrocytosis (larger rounder red blood cells) then that will take a few months to correct.

whilst 5mg is a dose given for a short time (1 month or so) to correct a deficiency (and would be the standard treatment in the UK) it is not a maintenance dose. You should not take doses of more than 1000mcg daily for a long period of time as high doses can cause problems.

Unless you know you have a B12 absorption problem (and having a thyroid problem doesn't mean you have a B12 absorption problem, just that there is a higher chance that you will develop one, I would cut down on the amount of b12 supplementation. Raising B12 levels above the normal range can cause problems for some individuals and the doses you are taking would certainly do this in the absense of an absorption problem.

The reality with B12 is that the normal range is extremely large. Individuals tend to sit at a specific point in this range that is right for them and maintain their levels at this point using stores of B12 in the liver. However, if you have an absorption problem this maintenance of levels doesn't apply.

The optimal B12 level for an individual is where your B12 levels sit without supplementation. Serum B12 can be a useful test if it is used to looking for falling levels over time but supplementation means that you loose this comparison to base-line making it impossible to spot an absorption problem from drops in levels of B12.

[Arabella33 in reply to Gambit62]

I agree, it was an active b12 test off supplements and I can only assume I’m in the top quarter of the range or above so it’s not too bad.

I think I’ve had folate deficiency a long time I have brain fog I’m hoping it’s down to this and I can resolve it. I did a test that showed larger red blood cells but they were at the top of the range not over.

I’m not planning on taking the large dose for long and I will retest in 8 weeks.

I don’t know about b12 I don’t think I have an absorption issue , how would I know ? I was planning on supplementing in case I was pooling in some way. I didn’t think I could hurt going above and I want my symptoms of brain fog and depression gone as soon as possible.

I’m also waiting for a genes test to come back to see if I have the mthfr gene but I’ve been keto a long time so my deficiency could well be dietary although it is very low.

Thanks for you help

[Gambit62 Administrator in reply to Arabella33]

With the active B12 levels you have I really wouldn't bother with supplementing. Although B12 deficiency and folate deficiency have very similar symptoms because they are used in a lot of the same processes going on at the cell level having higher B12 levels isn't going to affect how these processes run - just making sure that you are no longer folate deficient.

The best forms of folate come from diet so if your diet is deficient I would certainly look at correcting that rather than embarking on long-term supplementation

[Arabella33]

Thank you, what are the processes involved ?

I’m carnivore or trying to get there as I have other things wrong so it could be why I’m deficient although I used to eat a lot of leafy greens which makes me think I’m mthfr as I’ve had cognitive issues a long time

[JanD236 in reply to Arabella33]

You’re not deficient in B12 but you are a bit low on folate. Folate levels respond quickly to diet/supplementation and I note that you say that you ‘used to eat a lot of leafy greens’. If you’re not currently eating much in the way of folate containing food that could be a reason for your low level.

Apparently a lot of us have the mthfr gene and for most variations of it, it causes no problem at all. It may be best addressing your diet first and if this does not resolve matters then look for more complex (or other) reasons.

[Bellabab]

You also need to make sure you are hydrated in this weather.

[Ryaan]

Doctor should have prescribed 5mg Folic Acid to raise your Folate levels.

[Arabella33 in reply to Ryaan]

I agree, I have had the genes test for mthfr and ordered the 5mg to take for a short time. My cognitive function is fuzzy is this typical do you know ?

[Ryaan in reply to Arabella33]

Sorry I don’t know, but others here may know better about that.