Please help me get to the bottom of my brain fog!!

[Whatiswrongwithme]

Hello newbie here 🖐

I have had brain fog / dizziness since last November, I had blood tests back then which came back with the following :

Ferritin - 4 Normal range 10 - 291

B12 - 525 Normal range 211 - 911

Folate - 3.4 Normal range > 5.40

I was given 5mg folic acid for 3 months and Ferrous sulphate 3 x daily, I had my bloods re tested 8 weeks later and unfortunately I don’t have the results myself but I did write down my iron and folate levels which were :

Ferritin - 32

Folate - 20.7 (Same ranges as above)

I did feel loads better, but they stopped my folic acid, I buy ferrous sulphate myself now and doctor told me just to do 1 X daily which I have done ever since.

Last few months started to feel horrible again, bit drunk feeling, like my mind takes a minute to catch up to my movements, not really here type feeling. Rang doctor arranged bloods again and this is the results :

TSH level - 1.08 normal range 0.49 - 5.23

B12 - 580 normal range 211 - 911

Folate - 9.8 normal range > 5.40 (there’s a note underneath says within normal limits?) No idea what the limits are as >5.40 is all it says

Ferritin - 42 normal range 10 - 291

Haemoglobin estimate 139 normal range 115 - 165

I have just realised today that while my iron is still climbing, my folate has again fell, from 3.4 it went to 20.7 and now it’s fell down to 9.8. Do you think this could be causing it? Or anybody any ideas on reading blood results? I know nhs ranges are very varied

Thank u x

[Nackapan]

Perhaus you need a daily maintenence dose of folic acid. ? 200-400mcgOr have a multivit with it in.

Sometimes my bloods to not relate to how I feel.

Are you on b12 ?

[Whatiswrongwithme in reply to Nackapan]

Thanks for the reply, no I’m not on b12 from doctors but I did use a b12 oral spray back last year, I have since last week starting using this again

[Gambit62 Administrator]

The results imply that you may have a folate absorption problem, but it is also true that folate is much more responsive to dietary intake than B12. The normal range for folate shows less variance than the normal range for B12 so if you are still in range that is okay. The best sources of folate are from your food so worth looking at your diet to make sure it is high in folate rich foods - eg green leafy vegetables.Folate and B12 are used together in many of the processes going on in your cells - and the symptoms of deficiencies in either have a big overlap as a result.

The symptoms of folate deficiency tend to develop very quickly whilst those of B12 deficiency are much slower to develop - you seem to have described a rapid onset which would be consistent with folate deficiency without B12 deficiency

The results aren't indicative of a B12 absorption problem but if the spray helps with the symptoms then suggest you keep going with it.

The difference between the two B12 tests is in the noise range for the tests (ie 20%) so not significant.

However, because both folate and B12 are mainly absorbed in the ileum it is common for absorption problems to come together.

[Whatiswrongwithme in reply to Gambit62]

Very informative, thank you very much! I will definitely look into my diet, I do feel it could be improved with the aspect of adding more folate related food. I’m wondering if to ask the doctor if they will prescribe me 5mg folic acid again or just use the normal over the counter ones to see if I see a difference

[Cherylclaire Forum Support in reply to Whatiswrongwithme]

When I first had B12 deficiency, my hair was falling out and my gums were bleeding (among other symptoms). This continued despite B12 injections. My folate and ferritin were checked and found to be low-end but in range. I was given the three months' treatment anyway, as GP thought that these two symptoms in particular were more likely to be folate/ferritin related. Like you, my levels upped and then dropped again. They were very erratic and needed monitoring for a couple of years before I got them stabilised. It was necessary for the GP to monitor levels closely- so that I could adjust supplements accordingly.

I took a good all-round multivitamin and mineral tablet daily, and took additional folate and ferritin as and when necessary. Even at worst, I never had more than 800 mcg of folate a day. It took me about two years to get the balance right. My last blood test results (Nov 2020)were the best yet. I have recently stopped taking the multivitamin and mineral tablet because I have improved so much. Watching hair and gums closely -as unlikely to get a blood test any time soon !

Try for about 60-80 ug/L as a ferritin level (GP said below 60, can be symptomatic), and in top 1/3 of range for folate - if no range given, try for about 15 ug/L (my GP told me to stop when >20 came back !). Both folate and ferritin can cause problems at high levels too -so monitoring important.

Get vitamin D tested too -if you haven't already had that tested. I had a Dexascan -which showed osteoporosis of the spine, so now have vitamin D prescribed. Thyroid could also do with a check if not done recently.

There is currently a hold-up with blood tests, as you have probably read, so you may have to wait for a while.

Good luck in your search and don't give up.

[deniseinmilden in reply to Gambit62]

I am in awe of your such excellent answers - thank you.

[Whatiswrongwithme]

Thank you so much, this helps massively. I have started taking a folic acid tablet once a day and thinking as my iron has only slightly climbed in the last 8 months I may do 2 x daily during my period and then stay at 1 X daily at other times, yes I have heard about the blood tube shortages. I will speak to doctor this week (he doesn’t believe it’s my vitamins) and tell him what I plan to do and hope he agrees to test my blood levels later this year. Thanks again