How much folic acid

[DiNL]

Hi all, I’m still battling to understand how much folic acid i should supplement. My last folic acid blood test showed a level of 32. I know the optimum level is between 15-20. I am injecting daily with hydro. Since my last blood tests have all showed around 30 for folate i stopped supplementing. But I am concerned that this is not enough. When I started injecting in December my folate was 13.2.

It rose pretty quickly. What do others do that are on daily injections? How much do you supplement with ? My bcomplex has 400mg in it but I reduced that down to once a week as my folate was at 32. I think I should be taking it daily but am concerned I’m getting too much folate but at the same time worried that I’m not utilizing the b12 I’m injecting. Any advice?

[clivealive Forum Support]

Hi DiNL

Folate (B9 - Folic acid) is a water-soluble B vitamin that is naturally present in some foods, added to others, and available as a dietary supplement so like with B12 any excess is excreted via the urine,.

Personally I take 400mcg of folic acid every day and have done for decades but then I have had P.A. for over fifty years following gastric surgery.

Do you know what your iron level is?

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. Folic acid is also being "fortified into" many breakfast cereals and of course can be sourced naturally by eating plenty of green vegetables.

I am not a medically trained person

I wish you well

[DiNL in reply to clivealive]

Hi Clive Alive,

Thank u for replying. I am also iron deficient and take heme iron to supplement. My last ferretin levels were in the 40s, which is still low… but it has been going up slowly with heme iron. I can’t remember the actual level.

I have 400mg in my b complex of folic acid. I think it should be safe to take that daily. I was worried that my folate levels were too high and therefore stopped supplementing. Some groups advise 5mg a day. I can’t imagine how high mine would be if I did that.

Thanks for your advice, Clive. I follow this forum and see your respond to others from time to time.

Many thanks,

[bookish in reply to DiNL]

Because your serum folate was a bit low and went up with your B12 and B complex, it may be that you are processing it properly, but I just wanted to make the point that the type of B9 (folate) can be important to some. I love my veg and had plenty of dietary folate, I also took a multi and then later a B complex, both of which had folic acid in. My serum folate was quite high, but still in range. I don't inject but take B12 orally (not PA to the best of my knowledge, but a functional B12). When I started to take methylfolate instead of folic acid, my serum folate actually fell to mid range, my blood looked altogether more healthy and I improved by some significant margin neurologically. I only take 400mcg and split it into three doses daily. I wonder if some of those who are taking very large doses of folic are doing so because a sledgehammer approach works for them ( a bit like some of us taking vast amounts of oral B12), but might actually find a smaller dose of the right type of B9 for them also does the job. Prescribed B9 is usually 5000 mcg folic, but more commonly this should be used for women at risk of neural tube defects in pregnancy. Too much folic can result in unmetabolised folic acid in the blood which is not desirable, and is happening in some cases due to folic fortification of food. This study talks of the potential benefits of replacing folic fortification with folate fortification, which wouldn't do the same thing negatively, but would still help with NTD prevention frontiersin.org/articles/10...

Best wishes

[DiNL in reply to bookish]

Thanks Bookish,

The folate in my bcomplex is methyl or MTHR variant. But I had previously been supplementing with regular folic acid. So I think I will just take the bcomplex now with the MTHR folic acid in it. I think that’s the same as what you suggested? Hopefully this will not sort of just sit in my system and not be working properly. I was worried that my folate was just sort of gathering and not doing anything, as my levels have been consistently at 32 then 33 then 30…. Without a lot of supplementation recently. They seemed to jump when I took folic acid 1mg a day! It climbed from 13.2 to in the 30s! I do eat a healthy diet with lots of veg and so on as well.

[bookish in reply to DiNL]

Hi, that sounds worth a try. Some people with MTHFR variants/SNPs struggle to tolerate any methyl form vitamins at all, others are ok. Probably because there are so many combinations of MTHFR SNP and others which also affect methylation. I always start low and slow and build if needed. Luckily for me I can tolerate methyl and felt miles better with the methyfolate. (I doubt that your B complex has pyridoxine as its B6, probably P5P, but if it is pyridoxine and more than a low dose, keep an eye out for neuropathy changes, as pyridoxine can be a problem.) Cheers

[wedgewood in reply to bookish]

No , pregnant women aren’t prescribed 5000 mcg of folic acid . They are prescribed 400 mcg .

[bookish in reply to wedgewood]

I'm sorry, I phrased that badly. I meant that women already deemed at risk of NTD pregnancies or further NTD pregnancies are given 5000 mcg. I'm surprised pregnant women not deemed at higher risk aren't told to just buy their own 400 mcg. Either way, synthetic folic doesn't suit everyone and higher is not necessarily better.

[Nackapan]

All women of child bearing age are recommended to take 400mcg folic acid daily.

You can get side effects from low folate

Mouth ulcers ect .

You can get side effects from too high a supplement .

Nausea ect.

It makes sense that needing a high level of b12 will unbalance other vitamins and minerals

Again it seems up to us to take what our body needs .

Stopping and starting supplements I think can give a seesaw effect .

Perhaps stick to a regime for at least 4 months .

I often have to point out to doctors ' my good 'in range ' levels' in blood results are because I take daily supplements!!

I have a good diet but can't seem to absorb enough of everything anymore.

Put on weight and highered cholesterol trying !!

So back on less but good food .

Liver off the menu at present. !!

Everything I've read and told by G.p is its safe to take 400mcg folic acid or less daily .

A higher dose short term if deficient.

( always some need different doses of course prescribed. )

It's water soluble but like b12 any excess does not get peed out instantly hanging around needing to be processed .

That I do not fully understand.

Labs don't test folate here more frequently than 4 monthly .

Perhaps an indication. ??

Going by your post it doesn't seem you've been deficient .

So on track.

Can't see why you wouldn't be utilising the b12 injected .

It's a minefield.

Not sure if there is a definitive answer

[DiNL in reply to Nackapan]

Thanks Nackapan,

This is reassuring to read. Ok I think it’s safe to go back on to my daily bcomplex supplement with folic acid in it. I was making good progress with my PA symptoms, so much better than I was in December! But I tried to reduce my daily injections and I think that’s when my symptoms started to come back. Then I got scared that they were coming back because I had stopped the folic acid in my bcomplex!

Just got myself into a pickle again. Today, I am feeling better and will do blood tests next week again. Then they check my folate levels and thyroid and iron etc.

Many thanks for replying