Hi,
I was diagnosed with pernicious anemia in October and had the B12 loading doses - i also took 1000mcg a day sublingual following that and 3 month later my b12 is 877ng/L.
My Serum Folate was 6.5 back in october and in the following 3 months dropped to 2.7mg/mL and wasnt treat in october it was considered normal.
My question is, is low folate a common symptom of pernicious anemia or should i be concerned?
Many thanks
Sorry - I should have asked at the same time, it seems my potassium is also low - is this also linked?
(I also have autoimmune Hypothyroidism)
Thanks in advance
Banana s have both potassium and folic acid.
Yes it is common. You could take 400mcg folic acid daily.
Low potassium usually during loading doses can happen.
Get some more by diet.
That should sort it out.
Low salt is another potassium source .
Perhaps on next blood test get vitamin D tested and iron and supplement if needed.
Potassium only with food.
though.
coconut water
Banana ect.
More leafy greens dried apricots for foliate.
if you had macrocytic anaemia before you had loading shots that can cause a drop in potassium levels because the potassium is used in making healthy new red blood cells.
When you talk about low are you talking about low in range or below the normal range - if below the normal range then talk to your GP about the potassium. If both folate and potassium are still in normal range then it really is unlikely that you have a problem.
B12 levels behave in a different way to potassium and folate levels because B12 is normally regulated by stores in your liver at a constant point for the individual. Folate and potassium aren't regulated in this way so are much more dependent on dietary intake.
It is quite common for people with B12 absorption problems to have problems absorbing other vitamins and minerals. Most commonly affected are folate and iron.
The best source of folate is food but it shouldn't hurt to take a daily supplement (say 400mcg - which is quite cheap to get from a supermarket). Suggest you speak to your GP and or a pharmacist if you feel that you really are deficient.
The high B12 result is difficult to interpret as it is most likely down to the injection and how long it takes you personally to remove excess from your blood. Testing B12 levels after starting injections isn't recommended because of the difficulty of interpreting the test
Scientist, not medic.
Macrocytic [large] red cells as a result of megaloblastic change in the bone marrow can be caused by a deficiency of B12, or folate. On treatment for anaemia, potassium will fall, but it's temporary and there's enough in a normal diet to cope with this. If the megaloblastic change is due to B12 deficiency, correction of that will result in a fall in folate, but a normal diet ought to fix that.
Folate supplementation in the presence of untreated B12 deficiency is unwise.
Rather than getting bogged down in trying to interpret B12 and/or folate levels during treatment, a full blood count ought to demonstrate response. Typically, the MCV should fall, the RDW should rise temporarily, the Reticulocyte count will increase and the Hb will rise. Some of these will take a while, and the more severe the anaemia, the more spectacular the lab response can be!
It's worth discussing your concerns with your GP. It's why they are there.
Good luck.
thanks for your responses all. I do have an appointment next week to discuss with Doctor, i just like to try and understand reasoning for some of these things as the folate and potassium were ok (just in normal range) prior to b12 3 months ago and after treating b12 they are now both below normal range.
I loaded up on some brussel sprouts last night and see that low salt has potassium chloride in it, so i will sprinkle some of that on my sprouts!
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