Folic Acid and B12 injections

[B52s]

I have always had low Iron and Folate but until recently my GP has done nothing to correct the levels. It was a diagnosis of Oral Lichen Planus to have my Haematinics checked, I have also been diagnosed with Bile Acid Malapsorption.

I was put on B12 injections for life but my folate has now gone down to 1.7ug/L from 2.3ug/L.

I really struggle to tolerate oral medication but my GP has prescribed me Folic Acid 5mg daily. Could someone please tell me if this might be too high as I see that the recommended daily dose 400mcg. As ever you read so many different things its hard for me to tell if that is too high Knowing that I am going to struggle to tollerate them with my tummy. Also is it usual for the Folate to go down after B12 injections

[Foggyme Administrator]

5mg folic acid daily is the right dose for someone with a proven folate deficiency - which you obviously have. It’s given for 3-4 months and then your GP should check your folate levels to ensure that your deficiency has been resolved. 3-4 months is usually long enough to right most deficiencies. 400mcg is what’s called a maintenance dose. Some need that daily to prevent falling back to a deficient state - some don’t need any. Difficult to say as a general 'rule' because we're all different. Best thing would be to correct your deficiency, then take 400mcg daily, and after 3-4 months ask your GP to check your folate levels again. This will allow you to see if the 400mcg is preventing deficiency or, indeed, identify if levels are getting to high - in which case you likely don’t need folic acid supplements. (Over supplementing with folic acid can give some quite nasty side effects (terrible insomnia being one) and long term over-supplementation can cause potentially irreversible neurological damage - amongst other things).

Folate doesn’t go down when receiving B12 injections. However, those with absorption issues sometimes get other vitamin or mineral deficiencies too - folate, iron and vitamin D being the most common ones. So, hence, some take the 400mcg folic acid as a maintenance dose and some also need to supplement with vitamin D and iron. Both vitamin D and iron can be toxic if over-supplementation occurs, so best taken under medical advice (especially the iron as too much can cause iron overload which is dangerous).

Good luck.

[B52s in reply to Foggyme]

Thank you for your reply. The reason is the GP put the tablet on repeat with no instruction of duration.

I also have vitamin D deficiency and Iron. The main problem is that as I have said I do not tolerate oral medication very well. I had a right hemicolectomy for bowel cancer.

I spoke with an Haematologist who if nothing changes in the next 6 weeks is going to arrange an Iron infusion. The Vitamin D is proving a bit more of a challenge for them as I came out in a bad rash when I tried Baby iron drops. The GP has asked both my Gastro consultant and Haematologist for advice and neither has come back to him.

After my 2nd Covid jab I had bad bruising above my Hip. The GP did several bloods and a LDH test came back out of range at 266. That is 25% higher than the normal range. Because the GP did not know why he again has asked for Advice. I have had a look around myself and see that PA could be the reason. Have you heard of this before

[wedgewood]

5 mg is OK for a short while , say 3 months outside. I’m sure your GP knows this Just to get your levels up , then afterwards a maintenance dose of 400mcg . As you are prescribed B12 injections for life , then you must have P.A. . or you’ve had a stomach operation that interferes with B12 absorptionIf you really struggle with oral folic acid , I have seen B12 ampoules with folic acid on some German online pharmacies .

[Miss-guineapig]

Hi B52, My Dr prescribed my 5mg daily for four months to get my levels back up, I believe that is the right treatment. After 4 months she suggested 5mg every second day which I now take. I am also on B12 injections. I know there has been discussion here re 400mcg doses but I have spoken in depth with the pharmacist and my GP and feel totally reassured that 5mg every second day now ( or even daily for some people) is correct for me. Wishing you well x

[Miss-guineapig]

…meant to say I have totally no side effects and folic acid. It is just so important to produce healthy blood cells, and I also take D3 which I just buy myself. I work as a nurse and have never worried in the slightest re 5mg dose and have explored this fully on the back of other comments. X

[earthnymph]

Hi, I don’t know enough to offer advice, I took folic acid from GP for years on repeat prescription 5mg daily. After reading on here about the dangers I reduced to 5mg once a week. I’ve recently had advice from a nutritional chemist and I’m going to try methylfolate 400mcg daily. Apparently methylfolate is absorbed better. Might it be whatever is used as the base of the tablets that you are reacting to? Might there be another make or type that is better for you? I’m sorry I don’t know how to find things like that out, but there are lots of people on here with very useful knowledge 😊

[Natural1970]

I am taking folic acid tablets daily, 5mg. I also have b12 injections every 12 weeks. I don't really see much of a change at all. Maybe only balance. I continue to feel other symptoms though.