Query re. folic acid dosage and relat... - Pernicious Anaemi...

Pernicious Anaemia Society

32,623 members23,983 posts

Query re. folic acid dosage and related issues

Yervaud profile image
14 Replies

I’m still confused with regard to correct amounts of folic acid and B6 when injecting B12 EOD or ED, assuming it’s for life.

Is there a danger of overdosing folic acid or B6 do we know?

Also not entirely clear about taking iron if spare folic acid becomes ferritin and is stored as iron. Or if this is correct.

Sorry if this is a question you are tired of answering and I have missed the answers.

Written by
Yervaud profile image
Yervaud
To view profiles and participate in discussions please or .
Read more about...
14 Replies
helvella profile image
helvella

There is a problem with too much folic acid - some people feel very ill. For example, there are a number of reports on the forum of people prescribed 5 milligram tablets and being unwell. Reduce to 200 or 400 (typical supermarket product dosages) and they are OK.

B6 can also cause many problems including peripheral neuropathy if taken in excess. But the form of B6 also appears to be important.

Have a look for B6 in my vade mecum.

helvella.blogspot.com/p/hel...

Yervaud profile image
Yervaud in reply tohelvella

thank you helvella. Will study.

Treesong2023 profile image
Treesong2023 in reply tohelvella

Your Vade Mecun. Wow. It's an awesome knowledge resource.

Thank you.

👍👌

Nackapan profile image
Nackapan

As far as I understand it too much b6 can exasperate neurological symptoms I've read.It's not needed for b12 to work .

I used to take it for PMT but a low dose.

Tried it again a few years in with no ill effects

You only need to supplement folate if your bloods show a deficiency.

Always after b12 treatment has started.

Only a prescribed high dose is given if bloods dictate and for a very short period.

Then bloods repeated and the high dose stopped if folate levels up.

I only took 400mcg and within 2 months was above the reference range .

Again everyone needs to find their maintenance dose if it's needed..

However most multivits have 200-400mcg

The NHS advise up to 400mcg daily for mentrating women .

Iron and ferritin ;

Again by blood results.

I need to take a low dose of iron to keep my ferritin from falling and HB static.

Ferritin sits around 58 at present . Had dropped . Told to keep it around 50-70 if symptomatic.

Gp prescribes the iron.

Iron has to be looked at all together and is too complex for most to interpret unless a doctor.

Vit D is another supplement I take with k7 and is common to be low if an absorption problem going on.

Obviously food the best way.

Different ways of eating.

Vit c to help absorb iron.

Smaller iron rich food portions like meat over the day.

Folate rich foods you csnt overdose on.

Sun on upper torso vit D

It's useful if possible to go by old blood results to see what you personally operate on.

If a large dose of b12 needed ( most of us) it does knock other nutrients out of whack but does settle.

Another minefield .

I've tried different things.

Presently back to a standard multivit I alternate as supermarkets have slightly different mixes.

I do take vit D as well

Hope helpful .

Others know more .

Treesong2023 profile image
Treesong2023 in reply toNackapan

Hi Nackapan. Quick Question if I may? If you have a folate deficiency, or low folate. How long after b12 SI do you take the folate supplement...? A week...?

With many thanks 🌻

Nackapan profile image
Nackapan in reply toTreesong2023

I'm not sure .I imagine after a b12 Injection as it goes strsight into your blood it coujd be sooner than a week?

Yervaud profile image
Yervaud in reply toNackapan

Thank you Nackapan. Great help. Lost faith in my doctor re. monitoring bloods or having a clue what to do with levels / PA (and Long Covid in my case). So been trying to follow advice on here and Gez Medinger’s Long Covid u-tube et al.

But I see I’ll have to go back to asking them. I paid for bloods when I saw an endocrinologist privately in December. But can’t afford such things now. So all trial and error and going by how I feel.

Nackapan profile image
Nackapan in reply toYervaud

Yes I write to Gp and request a blood form.

FlipperTD profile image
FlipperTD

Scientist, not medic.

If you really require B12 for life, by injection, you can't overdose on it. If you can manage with oral B12 the same principle applies.

As far as folate goes, then 'little and often' is the watchword. We don't store folate so we need a ready supply, and it's abundant in green leafy stuff. Excess is best avoided.

Ferritin & iron: Ferritin is a storage protein for iron, but it is also an acute phase reactant, so it will go up in inflammatory conditions regardless of the iron status. It's a useful test for iron status but not infallible, that's why we have a range of other indicators too. Don't be tempted to take iron in excess; it's toxic.

A full blood count will give you a good indicator of the general state of your blood. If the MCV (&MCH) start to rise, there's probably something causing megaloblastic change in the bone marrow. If the MCV (& MCH) start to fall, then it's likely to be an iron issue.

Iron deficiency is generally a symptom of 'something else' and that's where your doctor comes in!

Yervaud profile image
Yervaud in reply toFlipperTD

Thanks Flipper. As I say to Nackapan, no-one in my local clinic has any knowledge of B12 deficiency or Long Covid. They’ve been kind and patronising and let me take care of myself. Sadly, I can’t do regular bloods.

Cherylclaire profile image
CherylclaireForum Support in reply toYervaud

My GP would regularly test folate, ferritin, vitamin D, thyroid TSH and FT4, but not B12. "No point" she said - as always over measurable amount because of injection frequency.

Since Covid, many changes in an overstretched health service - three excellent GPs left to work in rapid diagnosis in hospitals and no continuity now. One retired GP returned to help out the practice. Access difficult. Monitoring unlikely. Probably the same story everywhere.

Luckily I have stabilised and am also more aware now of what might be a sign, and still seeing an Oral Medicine consultant at hospital, who has been keeping an eye on ferritin level. GP wanted it above 60 ug/L - he preferred 80 ug/L, which was a bit of an effort. Keeps it above level at which symptoms might occur.

donnabrain profile image
donnabrain in reply toFlipperTD

Agree, you can't overdose on b12 as it's water soluble, but op was asking about b6, which can be toxic

helvella profile image
helvella in reply todonnabrain

Being water soluble is not, on its own, a basis that you can't overdose on it.

Sugar, salt, folic acid, pyridoxine (one vitamer of B6), hydrogen cyanide - all water soluble, all overdosable.

FlipperTD profile image
FlipperTD in reply todonnabrain

Well observed!

Not what you're looking for?

You may also like...

Correct dosage of folic acid and ferrous fumarate for optimum effect of B12 injections?

@[441725] and others. Please could you confirm what is the correct dosage of ferrous fumarate and...
rebs48 profile image

Folic acid and digestive issues

Has anyone suffered loose bowel after starting folic acid? Only been on it a week and started...
Chickens44 profile image

Folic acid query.

Hello, I have PA and have 3 monthly B12 injections, I'm always low in Vit D and Folate which my...
Brownie49 profile image

FOLIC ACID

I was told that B12 injections would not be effective if B9 was not supplemented? I was advised to...
Bellabab profile image

Folic Acid query plz

Hi to you all, I love this site you are all so knowledgeable! I was diagnosed with PA in 1992 when...
miniskirt profile image

Moderation team

See all
Gambit62 profile image
Gambit62Administrator
Foggyme profile image
FoggymeAdministrator
taka profile image
takaAdministrator

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.