I have had my bloods done recently as I have been feeling “off” dizzy/off balance, exhausted, twitchy eye lids, burning sensation on the right side of my mouth, breathless, palpitations, for a while now. I have had low folate a few times over the past couple of years for which I have been prescribed 5mg of Folic Acid for 4 months, however usually after I have been taking it for 3 months I start to feel worse than I did before taking it so never manage to complete the full 4 months.
Any way to cut a long story short my results are as follows:
Serum Vitamin B12 357 ng/L (197.00-771.00ng/L)
Serum Folate 15.7 ug/L (3.90-26.80ug/L)
Both state normal/no action.
Previous Folate tests have been <2 but then have returned to normal after taking the folic acid, however within 6 months have dropped again.
I have taken no folic acid for the past month.
Any advice or opinions are very welcome 🙂
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Shazy-B
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Do you have previous serum B12 levels that were much higher eg 430 or above? If so that would indicate a B12 absorption problem. Otherwise you could monitor again in a few months to see if there has been a significant drop, eg result below 270 which would again indicatean absorption problem
Otherwise both results look okay (which is what the lab comment is saying).
Note that you have hashimotos. Whilst this can affect B12 absorption, or, because it is an auto-immune disorder, increase the probability of also developing PA this isn't always the case.
Includes the statement "In the presence of discordance between the test result and strong clinical signs of deficiency, treatment should not be delayed to prevent neurological impairment"
NHS article B12 deficiency and Folate deficiency includes statements
"Functional vitamin B12 deficiency
Some people can experience problems related to a vitamin B12 deficiency, despite appearing to have normal levels of vitamin B12 in their blood." This comment is in Causes section.
"But some people can have problems with their normal levels of these vitamins, or may have low levels despite having no symptoms.
This is why it's important for your symptoms to be taken into account when a diagnosis is made."
MMA, homocysteine and Active B12 (Holotranscobalamin) tests may be helpful in diagnosing functional B12 deficiency.
This research article mentions a patient who suffered SACD, sub acute combined degeneration of the spinal cord due to B12 deficiency despite serum B12 being normal range.
Table 1 in above article is about frequent misconceptions (wrong ideas) about B12 deficiency that health professionals may have.
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.
"I have had low folate a few times ...... have been prescribed 5mg of Folic Acid for 4 months ....... after I have been taking it for 3 months I start to feel worse"
I have read that it's vital that both deficiencies are treated in a patient with B12 deficiency and folate deficiency. B12 treatment would usually be started first.
I wonder if the reason you were feeling worse after a few months of folate treatment was because you possibly had/ still have a B12 deficiency that was not being treated.
NHS article on B12 and folate deficiencies includes the comments
"Before you start taking folic acid, your GP will check your vitamin B12 levels to make sure they're normal.
This is because folic acid treatment can sometimes improve your symptoms so much that it masks an underlying vitamin B12 deficiency.
If a vitamin B12 deficiency is not detected and treated, it could affect your nervous system."
See Cautions section in above link which says that folic acid should never be given on its own for PA (Pernicious Anaemia) or other megaloblastic anaemias caused by Vit B12 deficiency as this may lead to SACD, subacute combined degeneration of the spinal cord.
I have learned that vitamins make a huge difference in the way we feel...even if tests are in what is considered the "normal" range.
Have you had more indepth tests done? Gene mutation or instrinic factor? I have read that some show normal range for b12 and others only to find out they're actually deficient.
I agree with others that taking b12 with folic acid work together really well. That could help.
I’m sure I have been tested for coeliac and that came back “normal” too, although I definitely feel that there’s something going on there as quite often after I eat particularly bread/pasta I do get stomach pains!
If that test wasn't within the past couple of years, you really need to ask your GP to re-test. A previous negative result does not rule out a current positive. Your GP should not refuse if you are symptomatic, and have consistently low folate levels. GP's are really bad at this, which is why:-
It is estimated that 1% of the population (UK) have coeliac = 672,000. Of those 24% have been diagnosed = 161,300. So over half a million people in the UK have not been dx.
1) tTG IgA which looks for a particular antibody to gluten.
2) Total IgA which checks which patients have IgA deficiency.
Patients with coeliac disease who have IgA deficiency will get a negative result in tTG IgA test because their bodies cannot make the antibodies that tTG IgA test looks for.
People with IgA deficiency will need alternative tests for coeliac disease.
See NICE guidelines Coelic disease or Coeliac UK website for list of alternative tests.
Did you have a Total IgA test?
Were you told by your GP to make sure you were eating plenty of gluten in more than one meal per day for several ẃeeks prior to blood being taken?
One reason for getting a negative result in tTG IgA test is that the patient was not eating enough gluten prior to test therefore not producing enough antibodies to register a positive result.
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B12 very high with normal blood results?. 
In need for advice/help with blood tests for B12 please
Blood results all \"normal\" still feel rubbish
DAILY VITAMIN B12 ORAL SPRAY
With normal levels of b12 can you still be deficient 
