Low folic acid

[E44E44]

Is it normal to have a headache and feel faint with low folic acid ? As I had a really bad headache yesterday just wondering if this is normal all new as just been diagnosed with low folic acid levels.

[Cb1963]

I'm not 100% sure, but other symptoms are breathlessness, especially walking short distances, you can get different problems, have you been prescribed folic acid tablets yet? Normally a 2/3 month period should boost your system I think I had 5mg daily if I remember correctly.

[E44E44 in reply to Cb1963]

Yes I have been told to take 400mcg folic acid tablets from the chemist which I have been on now for two weeks.

[Nackapan]

I had tjise symptoms from low b12 . My folate level was okay. Was your b12 level okay?

Usually tested together.

B12 should airways be treated first

[E44E44 in reply to Nackapan]

My B12 level are in the normal range 510 my folic acid levels are low 1.5 meant to be between 4 - 26 , I’m New to all of this as not long been diagnosed and all of this happened after having covid.

[Ryaan in reply to E44E44]

You should have been prescribed 5mg Folic Acid to get your levels up. The 400mcg is for daily maintenance dose if your levels are ok.

[E44E44 in reply to Ryaan]

I may go back to my gp this week as been getting headaches and feeling lightheaded

[clivealive Forum Support]

I assume E44E44 you are supplementing B12 hence coming to this forum

It is also important that your Folate level is monitored as this is essential to process the B12.

There is a complex interaction between folic acid, vitamin B12 and iron. A deficiency of one may be "masked" by excess of another so the three must always be in balance.

Symptoms of a folate deficiency can include:

symptoms related to anaemia

reduced sense of taste

diarrhoea

numbness and tingling in the feet and hands

muscle weakness

depression

Folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body

I am not a medically trained person but have had P.A. for 50 years

I wish you well

[Cb1963]

Hmm, it's a bit of a grey area for me, I have B12 injections, and I had a period of time where I went light headed, and was gasping for air whilst walking, I had a blood test, and then I was PRESCRIBED folic acid tablets from the doctors, not one's from over the counter from the chemist, so I'm unsure if these were a different strength, and if you have B12 deficiency others on here have more knowledge than me, and like I said I was taking 5mg tablets which I think are a stronger dose than what you are taking at the moment, and obviously if you're still struggling maybe a further blood test can help show if these tablets are working, but its all beyond my simple grey matter I'm afraid to say, sorry if I'm a bit vague 🙄

[Sleepybunny]

Hi,

Do you know your actual result for folate?

Have you had tests for B12, iron and Vitamin D as well and full blood count FBC results?

"just been diagnosed with low folic acid levels"

What does the GP think has caused your low folate levels?

I'm curious as to why GP has suggested 400 mcg folate tablets when folate deficiency is sometimes treated with high dose 5mg (5000 mcg) folate tablets for a period of time. Might be worth asking GP about this. Local pharmacist might also be useful to talk to.

In a patient with both B12 deficiency and folate deficiency, B12 treatment would usually be started first. Treating folate deficiency without treating a co-existing B12 deficiency can sometimes lead to neurological problems.

*My B12 level are in the normal range 510 *

It is possible to have severe B12 deficiency with a serum B12 result that is well within range.

UK guidelines suggest that people with the symptoms of B12 deficiency should be treated even if serum B12 is within range.

Some people can have functional B12 deficiency, where there is plenty of B12 in the blood but it's not getting to where it's needed in the cells.

I am not medically trained.

A few links that might be useful....

NHS link about B12 deficiency anaemia and folate deficiency anaemia

(People can have symptoms of folate deficiency and b12 deficiency without having anaemia)

nhs.uk/conditions/vitamin-b...

NHS link about B vitamins (mentions folate)

nhs.uk/conditions/vitamins-...

BSH Cobalamin and Folate Guidelines

b-s-h.org.uk/guidelines/gui...

NICE CKS B12 deficiency and Folate deficiency

cks.nice.org.uk/topics/anae...

BNF Folic Acid

bnf.nice.org.uk/drug/folic-...

The CCG/Health Board for your area may have its own local guidelines on treating folate deficiency and b12 deficiency so may be worth getting hold of the local guidelines.

Two useful B12 books (folate deficiency is mentioned)

"What You Need to Know About Pernicious Anaemia and B12 Deficiency" by Martyn Hooper

Martyn Hooper is the chair of PAS (Pernicious Anaemia Society).

BNF treatment info on B12 is out of date in this book.

"Could it Be B12?: An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (USA authors)

Very comprehensive with lots of case studies.

If you also have B12 deficiency from PA or other causes see websites below.

(folate deficiency is mentioned).

PAS (Pernicious Anaemia Society)

Based in Wales, UK.

pernicious-anaemia-society....

There is a helpline number that PAS members can ring.

B12 Deficiency Info website

b12deficiency.info/

I can post a lot more links about B12 deficiency and PA so let me know if you want more B12 info.

[E44E44 in reply to Sleepybunny]

Hi yes my folic acid levels (folate) were 1.5 meant to be between 4 -26 , all this flared up shortly having recovered from covid.

[E44E44 in reply to E44E44]

My B12 results were also 510 so normal range like yourself.

[Sleepybunny in reply to E44E44]

Hi,

Apologies for not spotting your reply before.

With a folate level that was below range, I am surprised that they did not put you on a higher dose folate supplement. Have you asked them why they recommended 400 mcg rather than 5mg?

Have you had further folate tests to see if your levels have increased?

Remember that a person with both B12 and folate deficiencies would usually be started on B12 treatment first.

BNF Folic Acid

bnf.nice.org.uk/drug/folic-...

Link about "What to do next" if B12 deficiency suspected (folate is also mentioned).

b12deficiency.info/what-to-...

Unhappy with Treatment (UK info)?

Letters to GPs about B12 deficiency

b12deficiency.info/b12-writ...

Point 5 in above link is about having the symptoms of B12 deficiency with a normal range serum B12 result.

Are your symptoms consistent with B12 deficiency (and/or folate deficiency)?

Symptoms of B12 Deficiency

pernicious-anaemia-society....

b12deficiency.info/signs-an...

b12d.org/admin/healthcheck/...

cks.nice.org.uk/topics/anae...

b12-institute.nl/en/symptom... (B12 Institute Netherlands)

Links to forum threads where I left detailed replies with lots of B12 deficiency info eg causes and symptoms, more UK B12 documents, B12 books, B12 websites and B12 articles and a few hints on dealing with unhelpful GPs.

Some links may have details that could be upsetting.

Some of the info will be specific to UK.

healthunlocked.com/pasoc/po...

healthunlocked.com/pasoc/po...

healthunlocked.com/pasoc/po...

"all this flared up shortly having recovered from covid."

I am not medically trained but I do wonder if an infection can increase the symptoms of an underlying deficiency/auto immune disease.

Have you had tests for PA and coeliac disease?

Testing for PA

pernicious-anaemia-society....

NICE guidelines Coeliac Disease

nice.org.uk/guidance/ng20/c...

Have you had tests for iron and full blood count (FBC) and vitamin D as well as folate and B12?

Forum members commonly report deficiencies of these nutrients.

Fairly common for forum members to have thyroid issues. Maybe worth putting any thyroid results on Thyroid UK forum on HU.

Thyroid tests

thyroiduk.org/getting-a-dia...

PAS website has this news article about the symptoms of Long Covid being similar to those of B12 deficiency.

pernicious-anaemia-society....

If you search online for "Covid B12 deficiency" it should show some interesting articles. Some may have upsetting details.

I hope you find the answers you need and find your way back to better health.

[FarmerDJ]

I am regularly diagnosed with low folic acid and my headaches are daily. Often a heat source will trigger a pounding and pressure in my head that's very uncomfortable. I'm a month into a 3 month course of 5mg folic acid tablets so hopefully as my levels come up, my headaches will subside.

[E44E44 in reply to FarmerDJ]

How long have you been on 5mg folic acid tablets ? I have finished 4 months worth and have been told to go back on my dose of 400 mg well I feel I’m back at square 1 as the 400 mg I notice a difference has tired and got mouth ulcers again ! So I have actually stopped taking them I do have an appointment at my GP with one of the Pharmacies about my meditation.

[FarmerDJ in reply to E44E44]

Just finishing another 3 month course. My 4th course in 3 years.

[E44E44 in reply to FarmerDJ]

I don’t really know what my doctors are playing at as I thought folic acid tablets are for long term

[E44E44 in reply to FarmerDJ]

Also do you have regular blood tests too ? As my doctors say I don’t need too so how the hell do I know if my levels are back up or not ?

[FarmerDJ]

Not since covid , I have to remind them every year to do it as I'm on levothyroxine too. GP services have been terrible since covid and it's impossible to get appointments these days. I've almost given up on them. Keep hounding them.