Why do I need to also supplement with... - Pernicious Anaemi...

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Why do I need to also supplement with a folate or a Complex B vitamin when supplementing with B12?

looking_for_answers profile image

Hi,

Spent a few hours last night trying to find scientific papers/writing on the need to supplement with folate when one supplements with B12. No luck. I'm sure I haven't searched for the right terms... could anyone help me? I don't understand the concept of balancing out the B vitamins.

I supplement with B12 (level 593 ng/L, ref range: 10-120. result of 1000mcg sublingual vitamin B12 Methylcobalamin 2 times a week) but take no folate (nor other B complex), given my folate is normal (16.8 ng/ml ref range: > 2.7).

Why would I need to also supplement folate (or take other B vitamins) when my folate levels are seemingly normal? I'd like to read more about it.

Many thanks!

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10 Replies
fbirder profile image
fbirder

If your folate is normal there should be no need to take supplements.

If you were to have Pernicious Anaemia then it is possible that you would need folate supplements. The condition that causes PA also causes a lack of stomach acid (achlorhydria). Absorption of folate from foods requires stomach acid to activate pancreatic proteases (needed to cleave the polyglutamate from folate).

As well as folate, this can also affect absorption of iron and Vitamin D. So people with PA are advised to take low dose vitamin D and to keep an eye on their iron levels.

However, as your B12 is so high with just oral supplements you obviously do not have PA so are much less likely to need supplements.

looking_for_answers profile image
looking_for_answers in reply tofbirder

Thanks fbirder . Appreciated.

Vps1980 profile image
Vps1980 in reply tofbirder

But if you use HCL would that make a difference? Xx

fbirder profile image
fbirder in reply toVps1980

No idea.

I tried betaine.HCl and found it too digital. One capsule wasn't enough, two was too much. One reason I stick to lime juice - much easier to calibrate to the correct amount.

Andypandy30 profile image
Andypandy30 in reply tofbirder

I’m sorry fbirder but many people’s b 12 level is high when supplementing as they can raise the levels in the blood but these people can still have pernicious anaemia as b12 is not getting to the cells .

Andypandy30 profile image
Andypandy30 in reply toAndypandy30

I would add that Vps1980 can get b12 levels rechecked in a few months and going by the symptoms and wether b12 remains high then further testing cannot be ruled out for pernicious anaemia In the future .of course all supplements should stop prior to testing for at least 4 months

fbirder profile image
fbirder in reply toAndypandy30

If they are absorbing B12 from oral supplements then they do not have Pernicious anaemia.

What you are describing, lots of B12 getting into the blood, but not enough in the cells, is a functional B12 deficiency.

Having PA can, as I describe, affect absorption of other nutrients. A functional B12 deficiency will not.

Andypandy30 profile image
Andypandy30 in reply tofbirder

So when supplementing with a b12 spray while it raises the level of b12 in the blood so results are then found to be high . That person could still have pa is this not right ?

fbirder profile image
fbirder in reply toAndypandy30

No.

B12 is not absorbed sublingually. The whole dose from a spray is swallowed and absorbed orally.

If you absorb B12 from a spray you do not have PA.

Andypandy30 profile image
Andypandy30 in reply tofbirder

Fbirder In my particular case my original level of b12 was 124 a very low level with severe symptoms . Whilst I did not know enough about pa and the prevalence in my family I was trying to help myself as doctors clearly were not . I supplemented with a b12 tablet from Holland and Barrett which did not help at all with symptoms . At this stage my b12 was 302 and doctor refused to treat me with injections . My point is that these tablets raised my b12 levels in my blood and I went on to be tested and diagnosed with pernicious anaemia as did several members of my family .

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