Advice about folate deficiency

[Luac]

Hi all,

I was recently diagnosed with Pernicious Anemia through the test after about two years of being diagnosed with B12 deficiency. I took the plunge and self inject fairly recently and that helps a lot.

In recent months my mental health has declined and I feel tired all the time. Chores like hoovering exhaust me - I need to lie down or crash on the sofa after that.

With the recent diagnosis of PA I had a FBC to check for iron deficiency. I have had that test before and I did not have iron deficiency. The GP has not gone through the results with me but when comparing to previous FBCs I suspect that iron levels are fine.

MCH and MCHC are elevated as have been over the past two years. I read up about that again today and read that this can be indicative of B12 and folate deficiency. A lightbulb moment happened - I have not considered folate deficiency at all.

Does the B12 injection cover that or should I be taking supplements for folate deficiency too and is oral folate effective? I have done quite a bit of research in to B12 - like many of you here - but I seem to have not considered folate at all. I wonder if I thought that folate and Iron were the same thing.

Apart from that, the blood test showed an elevated percentage lymphocyte and percentage monocyte. Should I be concerned about that?

Thanks in advance, I have had so much great support and advice from this group. You have been a real life changer.

[Nackapan]

Most can take 400mcg folic acid safely . What was tour folate level? My daughter needs this as a maintenance dose.

Ferritin iron vitamin d should be monitored too as often deficient with folate or b12

I cant comment on your other queries

[Luac in reply to Nackapan]

I don't know how to see what my folate level was, or indeed what part of the FBC tests for Iron deficiency. The only abnormal readings were: MCH 32.5; MCHC 366; %lymphocytes 46% and % monocytes 11%

[Nackapan in reply to Luac]

Ask for a copy of your blood results. I do every time now .My ferritin was much lower than it had been but because in range not commented on.

Mu daughters was 10 right at the bottom not commented on.

Have a look and anything you dont understand get your Gp to explain.

They are your results after all

[Luac in reply to Nackapan]

Thanks, I get a copy automatically through patient access app. Ive posted my results here but im not sure which is the ferritin reading, ferritin doesnt appear on the list in my results.

[Luac]

Haemoglobin estimation

168 g/L

Range 130 - 180

Total white cell count

6.5 10*9/L

Range 4.0 - 11.0

Platelet count

246 10*9/L

Range 150 - 450

Red blood cell (RBC) count

5.17 10*12/L

Range 4.5 - 5.5

Haematocrit

0.459

Range 0.40 - 0.50

Mean corpuscular volume (MCV)

89 fL

Range 80 - 100

Mean corpusc. haemoglobin(MCH) (this result is always high for me, sometimes higher than this

32.5 pg

Range 27.0 - 32

Abnormal

Mean corpusc. Hb. conc. (MCHC)

366 g/L

Range 315 - 350

Abnormal

Red blood cell distribut width

12.1 %

Range 11.5 - 14.5

Neutrophil count

2.6 10*9/L

Range 2.0 - 7.5

Percentage neutrophils

40 %

Range 40 - 75

Lymphocyte count

3.0 10*9/L

Range 1.0 - 4.0

Percentage lymphocytes

46 %

Range 15 - 45

Abnormal

Monocyte count

0.7 10*9/L

Range 0.2 - 0.8

Percentage monocytes

11 %

Range 2 - 10

Abnormal

Eosinophil count

0.2 10*9/L

Range 0.0 - 0.4

Percentage eosinophils

3 %

Range 0 - 7

Basophil count

0.1 10*9/L

Range 0 - 0.2

Percentage basophils

1 %

Range 0.0 - 2

[fbirder in reply to Luac]

I wouldn't worry about those values that are slightly out of range, especially if they are normally like that. The 'normal' ranges for most parameters are set so that 95% fall inside that range. So 5% of people will fall outside.

Your normal value for the MCV says you haven't got macrocytic anaemia which would show a folate deficiency. But that doesn't mean you don't have one.

A folate deficiency can be caused by a lack in the diet (not eating enough leafy green veg, pulses, liver, etc.). It can also be an effect of the lack of stomach acid which is normal for people with PA. That makes it hard to absorb folate from food (but not from pills).

It is recommended that all women of childbearing potential should supplement with 400 mcg of folic acid a day. I would extend that to anybody with a B12 deficiency that is being adequately treated. That would help keep your levels up and help you decide if your symptoms are caused by low folate.

[Luac in reply to fbirder]

Thanks, I will make sure to start supplementing!