Low folate and b12. Newbie

[Scipio99]

Hello all,

Newbie here 64 years old. Full blood count & other blood tests have just come back showing near borderline low b12 (230 as I remember) and sub borderline folate but only just - about 3. Unfortunately, my online records are temporarily unavailable to me. All other readings fine - haemoglobin, thyroid, sugar, etc. This is after I visited my GP mid Oct complaining of numbness and tingling in left foot (noticeable a couple of months ago) and just starting a little in other extremities. No other problems and feeling good otherwise. Doc did a thorough physical examination which was fine. Diet very normal and varied (not a vegetarian). BMI normal. Not on meds other than very occasional ointment for sebhorraic dermatitis. No gastric complications. Doc's put me on folic acid 5mg for 56 days and going back for re-bloods mid-Dec. He didn't mention pernicious anaemia.

I can't believe my diet is responsible for either the low b12 or folate but, in any event, can a folate deficiency of itself cause a reduction in b12 or, if I do have PA, is it that which is likely responsible for the low folate?

Thanks,

[fbirder]

STOP TAKING THE FOLIC ACID.

If you have a B12 deficiency (and it sounds like a distinct possibility) then taking high dose folic acid can exacerbate the nerve damage. ncbi.nlm.nih.gov/books/NBK1...

Contact your GP and demand a course of B12 injections. Only when you've started them should you take the folic acid, and then only for a month or two.

[Scipio99 in reply to fbirder]

Thanks fbirder for that. I've been taking the folic acid 5mg for 12 days and I'll stop it straightaway. Looking at the doses and durations in the table in that link you gave I presume it can't have done any significant damage so far. Looking at this website and other sources my suspicions were raised about the folic acid treatment before B12 was tested first.

I'll contact GP on Monday. If he says I should complete the course first should I consider self- treatment of B12?

[fbirder in reply to Scipio99]

You should ask your GP why he is ignoring the recommendations of the British Committee of Standards in Haematology, who say -

"The clinical picture is the most important factor in assessing the significance of test results assessing cobalamin status because there is no ‘gold standard’ test to define deficiency."

And

"In the presence of discordance between the test result and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."

onlinelibrary.wiley.com/doi...

[Scipio99 in reply to fbirder]

That'll be useful. Thank you.

[Scipio99]

Is it rare for pins and needles to be the initial symptoms of b12 deficiency? Upon recent testing all my bloods were within ranges except borderline b12 and folate just under and I can't honestly say I feel ill, tired, confused or display any of the other common symptoms other than this accursed tingling in my left foot and occasional minor numbness in the other extremities.

[fbirder in reply to Scipio99]

No I don't think it is rare.

It can be one of the first symptoms noticed. Others like fatigue, memory lapses, clumsiness, are often just put down to 'being older'.