Not had blood tests since before the pandemic. Just recieved my April 23 blood test results.
My Serum Folate is 3.6 ug/L Deficient being <3.9 ug/L
My B12 level tested at 661 ng/L (normal range 197-771) I take an oral methyl /adenosyn B12 supplement as never could get the GP to see that I was deficient in B12. I tested 191 in the day when 190 was the minimum normal. So took into my own hands and supplemented
My previous folate level in 2019 was 8
I believe folate level can fluctuate . So is it of any concern ?
Can anyone advise how to get my folate level up. I eat lots of fruit and veg
Supplements?
Many thanks
Lynne
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LynneG
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hello LynneG, I m very new to this and others on this forum will give you better fuller information but I believe that this is of concern. Serum folate and b12 levels are linked. You could look at pernicious anaemia society they have lots of useful information. All best wishes.
I use the Igennus Super B Complex - you take 2 tablets a day. The tablets are smaller than a lot of B Complex capsules so I like them as easier to swallow.
I highly recommend joining any of the Pa or b12 groups on social media. Or the b12 society. There are a number of issues here….
1. With low folate ( optimal is 18) the b12 is pooling unused, making it look higher than it actually is.
2. When b12 deficiency occurs not linked to diet, it must be treated by injections. Oral supplements are ineffective. In fact, they mask the issue as they artificially inflate blood results whilst the deficiency rages on. Folate supplementation needs to happen at same time as the injections.
This is all quite dangerous. Back in 2018 I was seriously ill because of these two factors. Like you I was caught in the no man’s land….horribly sick but unable to convince the NHS I needed help. I opted to learn to self inject….and recovered. No symptoms now except a little permanent neurological damage from being left so long.
Hi Zac 2022, I do appreciate your information. I can see now that you have pointed it out that without folate the sublingual B12 will just be accumulating. i obviously need to get my folate up as quickly as possible. I will have to continue the B12 sublingual for now until I can see the GP again before considering self injecting which is a very frightening prospect. Thanks so much
Sublinguals are included in oral supplements….only effective in absolutely massive doses. I highly recommend any of the b12 society and pernicious anaemia Facebook groups. They can help you get the injections you need.
Wow, this is interesting I’ve been so poorly for the last 2 weeks and I’ve had bloods which show just on the low side but not low enough for folate deficiency…I’ve had this before not as bad though I am so sure my folate and b12 are low I’ve had disturbed vision dizziness no mental clarity can’t sleep restless legs nausea finally got my hands on folic acid 5mg started perking up but my tounge is burning and looks like it has white strips on it! Why do these drs not listen 😔
Unless you have a severe folate deficiency, there is no reason to take 5mg Folic Acid. 5mg Folic Acid is 5 times the tolerable upper limit (set for safety reasons) and 25 times the RDA. B12 should always be corrected before any folate is supplemented. 400mcg is a safe daily dose if folate is found to be not deficient but somewhat lower than it should be and dietary folate sources seem not to be capable of correcting it.
Yes I have a folate deficiency have done for years GP put me on a 3 months course then within another 3 months I am symptomatic again and the process repeats
So basically you are having to permanently be on a supplement, food not being enough, as I certainly will take
I will see if this supplement I am taking now has made a difference to my level with my next blood test . GP said 4 months time. I did not accept the GP prescription, I do not want to take Folic acid which the NHS prescribe it seems. I wish to take Folate. As far as I know, Folic acid is lab made and has to be converted. Not good for older people.
My info about Folate v Folic Acid is from Chris Kresser (functional health clinician/website and podcast)
Wouldn't it be better in your case then as you obviously need to supplement, to take a full B vits supplement containing Folate (as many do) everyday. Goodness knows what your permanently declining levels through each 3 months, are doing to your Homocysteine levels, needed to protect your heart and brain. Has your GP been proactive and tested your Homocysteine Levels? It needs to be 6-7 or damage can well be occurring. (see Food for the Brain website.)
My (NHS) test taken at the same time as my Folate was recorded deficient. my Homocysteine level had shot up to abnormal levels - not good
CG007 "Yes I have a folate deficiency have done for years GP put me on a 3 months course then within another 3 months I am symptomatic again and the process repeats"
Yes, I've heard this story at least a dozen times. It is simply short-sightedness on the part of the physician. They prescribe 5mg, which corrects the deficency but not the underlying absorption issues. They then stop the folate, the person inevitably becomes deficient again, starts 5mg and the cycle repeats. I suggest a different approach. Once the deficiency is corrected, you might consider a lower dose, from 400mcg to 1mg. Simultaneously look into what is causing the deficiency - not enough folate in the diet or an absorption problem and see if that can be resolved. But stopped the folate suppementation dead abruptly puts you in a hamster wheel without resolving whats causing the deficiency in the first place is.
If you cant resolve the deficiency by diet or resolving an absorption issue you will likely need folic acid or folate supplementation for life but try to calibrate it to your labs and dont make massive changes from 25x the RDA to nothing unless you know the problem that caused it is now resolved.
Well Good Luck. If you do have IBD or Inflammation, the best thing I did is not eat gluten or any grains. Look up Dr Tom O'Bryan video interviews on you tube. Here's a quick overview
Hi CG007, As Technoid commented, I think you meant 5mcg just a typo. Please have your GP request a blood test for homocysteine. I always have homocysteine checked in my blood tests (NHS) You just need to phone your nearest hospital phlebothamy dept (or further afield) to make sure they can test for homocysteine in their labs as has to be in the labs within half hour to an hour from being drawn.
When my mum died with dementia /alzheimers. I asked my GP if I could have the test . She kindly agreed and have had ever since with my other tests. Originally my level was 9.9 (not good) although the normal range was higher than it is to day . Normal range today is up to 10. I was not happy,
I read the info on the Food for the Brain website about homocysteine and have listened to Functional doctors/clinicians health podcasts and it is always stated a level of between 6-7 (higher and you are setting yourself up for trouble re high risk of heart, stroke, and alzheimers /dementia. B12, Bvits, folate and other supplements like NAC to help to bring your homocysteine level down. The first year after testing , I got mine down to 8 and so was pleased with my progress in a year. However along came Covid and I didn't have any blood tests for 4 years. I was /am taking a 5000mcg sublingual methyl/adenosyl B12 . My folate was always a reasonable high level and so I never worried about folate. Hmm, now deficient and low and behold my homocysteine is now 14.1 ! No wonder my memory is now shocking. My B12 level is 666, (may not all be active B12) but it shows how important folate also is for ensuring homocysteine is low.
Homocysteine is created naturally from protein synthesis but is removed from the body during the methylation process, otherwise it builds up and poisons your system. Hence why it needs to be low. if folate or B12 have been/is low you need to check homocysteine levels to help you work towards getting it down
Read Dr Malcolm Kendrick's book 'The Clot Thickens' about the real causes of heart disease (guess what? It's not about cholesterol levels) Homocysteine is mentioned quite significantly though.
Unfortunately, with regard to Homocysteine, a 2017 Cochrane systematic review found:
"no evidence that homocysteine‐lowering interventions, in the form of supplements of vitamins B6, B9 or B12 given alone or in combination, at any dosage compared with placebo, or standard care, prevented heart attack or reduced death rates in participants at risk of, or living with cardiovascular disease. Homocysteine‐lowering interventions combined with antihypertensive medication had uncertain effects on stroke"
Trimethylglycine (TMG) can help to independently lower homocysteine and could be worth investigating for those who have persistent high homocysteine which B12, Folate and other B-vitamins seem unable to lower.
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There are many factors for heart disease risk but in terms of lipids, the best measure is ApoB, which is causative for heart disease. LDL cholesterol is sometimes used as a quick and dirty marker of risk but ApoB is the better measurement. A high LDL will often trigger investigation of ApoB but anyone at risk of heart disease should monitor ApoB closely. Even if LDL cholesterol is low or moderate, a high ApoB indicates increased risk.
Yes I know about ApoB but I have not been able to get a GP to test for. Typical NHS not into prevention
I am now taking TMG and folate and B12 and B vits to try and be proactive to reduce my homocysteine level.
However when my homocysteine was 9.9 quite a few years ago all I did was to take B12 (had then an acceptable folate measurement) and some other B vits and my homocysteine lowered to 8. So I don't really care what the Cochrane review found . Many of these studies are not worth taking notice of . I'm not incorporating Cochrane in with such studies/research as I know nothing of but I have my own personal evidence and so can easily dismiss
Thanks for the video link. I will view with interest.
The Cochrane review is not saying that supplementation of the relevant B vitamins does not reduce Homocysteine. It is saying that reducing Homocysteine in this way did not prevent heart attack or reduce death rates in participants at risk of, or living with cardiovascular disease.
Regarding Cochrane:
"Because of its rigorous and analytic methodology, standardization of approaches, and transparency, the Cochrane Collaboration is often considered to be the gold standard for meta-analytic reviews, is deemed robust against bias, and is highly trusted by clinicians."
A Meta-Analytic Review attempts to correlate all the research from the available clinical trials and form a conclusion on the totality of the evidence in the field.
Although not infallible of course, they typically produce robust analysis that represent the most accurate picture of what the current evidence shows in the particular area of research being studied.
Blinded, Placebo-Controlled Randomised Controlled Trials are considered the gold standard of clinical research and Cochrane collect the evidence from well run trials such as these to form a gold standard summary of the current state of research in that field.
It is a shame that ApoB will not be looked at. LDL Cholesterol can be a useful marker but is not foolproof.
Hi, yes when I re read your post , I realised that. Hmm, we can only try our best, and I really don't want a high homocysteine. Not sure what research the website Food for the Brain (where I originally learned of homocysteine and it's detremental effects if high) were based on
But possibly I come from a different perspective to you. I follow Functional Health Practitioners ( they travel backwards and find the root cause of a health issue) And Meta analysis of research is not necessarily something to pay attention to. There can be selective choices of which studies/ research they choose to include and also the patients they include in the original studies. Also it depends on who is funding and what result the funders consider desireable. I am not saying this is the case with Cochrane but I like to be skeptical especially if Pharma are funding. They certainly wouldn't wish for something as cheap and simple as vitamins to be effective for better health. And this will not change while ever Pharma are producing cholesterol lowering drugs and making trillions. As with Ancel Keys in the 1960's and his fraudulent 7 countries study on which the cholesterol hypothesis was/is still based. over 50 years later . Or the NHS food plate which the Govt advice is based on which affects us all with institutions such as hospital meals, school dinners, homes for the elderly, food producers even restaurants. Did you know there is not one molecule of fat in the make up of cholesterol
There are many practitioners who see the relevance of Homocysteine in heart disease/attack , stroke and brain health. Obviously vitamin K2 also plays a relevant part in heart health and the health of arteries. I think it is essential to take vitamin K2 but also to keep homocysteine at a low level (6-7) Fibrinogen also another marker in serum to pay attention to as this can be a massive indication of trouble a foot. Rheumatoid Arthritis patients of whom I am one are at high risk of heart , stroke, etc usually have an abnormal high fibrinogen level, so much so that it can be used to diagnose RA. So fibrinogen is another marker to lower with supplements ( ideal - the lowest third of normal range) and will be the reason for the gloomy forcast for RA patients
Please to widen your perspective read British GP, researcher and heart specialist Dr Malcolm Kendrick's book the 'Clot Thickens' 2022 and even 'The Great Cholesterol Con' (2007) Yes they've known the truth about Cholesterol since 2000 even earlier as Ancel Keys confessed his 'mistake' before he died. It is fascinating and Dr Kendrick's book 'Doctoring Data' will have you laughing out loud.
There's also the UK's 'Public Health Collaboration' which is a large group and growing of British health proffesionals, scientists and researchers who hold a conference in the UK and provide a video of the speakers presentations to be viewed . The Public Health Collaboration was started by a Liverpudlian GP who was disatisfied with his patients never getting better with the prescription based mentality x
Sorry for the delayed response but there was a lot to respond to in your post and I wanted to get my research right and not give a flippant answer.
Firstly, I wholeheartedly appreciate your skepticism in nutrition research, especially when considering the sources of funding. Although I don't believe a study should be dismissed entirely simply because of the funding sources, many industry-funded studies often (but not always) publish outcomes that are favorable to the funding source and should certainly be viewed with skepticism.
This is something covered very well by Marion Nestle in this talk
The Cholesterol or Lipid Hypothesis did not originate with (or depend solely) on Ancel Keys and the Seven Countries Study although he did play a major part in advancing the research supporting it. But as early as 1913:
"the Russian scientist Nikolai Anichkov showed that a high cholesterol diet was responsible for cholesterol in atherosclerotic lesions of arteries. The degree of atheromatous involvement was related to the amount of cholesterol uptake"
The Seven Countries Study was not fraudulent. This is a common myth usually spread by low carb advocates. Several nutrition experts wrote a whitepaper in response to prevalent misinformation about Ancel Keys, which stated the following (Seven Countries Study is abbreviated as SCS):
"The Seven Countries Study included exactly seven, and neither six nor 22, countries. Keys and colleagues did not cherry-pick the participating countries; they did not exclude France; they did not present or graph their data selectively; they did include dietary intake surveys in Greece during Lent intentionally, for reasons clearly articulated at the time, and with proof that this did not introduce any distortions; and they did analyze sugar in all the same ways they analyzed saturated fat, and reported just what they found."
"SCS provided invaluable information about the connections between diet and coronary heart disease, in addition to developing important tools for standardizing nutrition and diet research. Monographs published with five and 10-year follow-up data showed that coronary heart disease and mortality were significantly associated with diets higher in saturated fat.2,3 Follow-up data from 15 years of tracking all-cause and coronary heart disease mortality found that diets high in saturated fats were associated with increased risk for dying of heart disease, consistent with earlier findings.4 Allegations that SCS was deliberately designed in order to find specific, preconceived outcomes are decisively without merit"
from
"Ancel Keys and the Seven Countries Study: An Evidence-based Response to Revisionist Histories"
I have some minor disagreements in some sections, but overall it seems to present a relatively healthy dietary pattern.
You said:
"Did you know there is not one molecule of fat in the make up of cholesterol"
Paraphrased from Wikipedia: Cholesterol is a sterol (technically an alcohol) but classified by biochemists as a lipid (fats in the broader sense of the term).
So in a certain sense you could say that cholesterol is a type of fat, depending on how you classify things. But I dont get your point? However we classify cholesterol, the relationship of excess saturated fat (>10% of calories) to elevated LDL cholesterol remains.
"There are many practitioners who see the relevance of Homocysteine in heart disease/attack , stroke and brain health."
I never made any claims about Homocysteine in relation to brain health. I only pointed out systematic reviews showing that lowering homocysteine does not seem to reduce risk of heart attack. As such, it is possible that high Homocysteine might not be causal but may instead be a marker of ill-health.
"Big Pharma" owns quite a lot of supplement companies :
and makes a considerable amount of money from these.I'm not sure what the figure is for other countries but Americans spent $50 billion on supplements in 2021 according to one report (ref : eu.usatoday.com/story/news/...
Given that a large chunk of this money goes to large pharmaceutical industries which own supplement brands, I remain unconvinced that supplements are a wonder cure that Big Pharma is frantically trying to dissuade is from buying and covering up evidence of their effectiveness, lest we all recover our health from these pills. Why would they dissuade us from buying their own products? And clearly, if big pharma re trying to stop people buying their vitamins they are failing horribly given the $50 billion a year supplement figure quoted for the US for 2021.
Perhaps Big Pharma are intelligent enough to realize that they can sell both vitamin supplements AND prescription drugs because neither really tackle the root causes of poor health, so both are going to be ineffective and thus profitable for Big Pharma, well into the future.
Big Pharma are making tons of money with cholesterol-lowering drugs because most people are either unaware of or unwilling to take the necessary lifestyle steps to reduce their cholesterol and thereby lower their risk of heart disease. That is with the exception of hereditary hypercholesterolemia which may require medication despite best efforts with lifestyle.
On Malcolm Kendrick and Aseem Malhotra I think RationalWiki have made a good summary
Although I am far from happy with the current medical system or state of nutritional research, the influence and funding from big pharma and the food industries, the lack of nutritional knowledge among GP's, the arrogance and disregard for the suffering of their patients, the frequent resort to treating symptoms rather than uncovering and treating root causes, and lack of interest in preventative medicine, I don't feel that the answer to any of this is to reject all of the accumulated scientific knowledge and research and instead turns to pseudoscience, misinformation and nonsense like that being spread by Mark Hyman, Malcolm Kendrick and Aseem Malhotra.
Hi Zac2022,.. With low folate ( optimal is 18) the b12 is pooling unused, making it look higher than it actually is.
This caught my attention, as I thought B12 gets excreted and therefore wouldn't pool as such?
I'm pretty new to all this so I'm trying to understand.
Re folate, I've been supplementing 400mcg of methylfolate in a b complex for the last three months or so, but my folate has dropped from 14.8 to 8.98 (8.83-60.8).
Do you have any idea what could cause that?
Can low stomach acid (I'm hypothyroid and possibly undermedicated) mean that I'm not absorbing my folate supplements?
Or maybe folate fluctuates over time?
I'm upping my dose to 1000mcg folate and I'll retest.
My symptoms of exhaustion, anxiety, light headed at times, remain.
Hi LynneI too was diagnosed with a folate deficiency alongside my b12 deficiency. My folate was under 1.0
Last year I stopped taking a separate methylfolate supplement because it was also in a multivitamin I take. However, a few weeks ago I became aware that I was developing symptoms again. I reordered my methylfolate supplement and have been taking it every day , the recommended dose of 400mcg.
The improvement in my symptoms has been profound, and this despite a weekly self administered b12 injection all the way along ( Pascoe Depot ) . My involuntary eye muscle spasm has almost gone, and I have lots of nerve sensations in my feet, which I believe is from the uptake again. In short, I never should have stopped the folate, and I won't in the future , lesson learned.
I take a very nice food based methylfolate by Health Leads, which has no nasty fillers in it, and is the 400mcg recommended dose. It's available on Amazon.
Thank you so much for taking the time to provide your information, and to advise a good methyl brand. I am about to order I really do think that I also ought to take a good B complex to achieve a balance. But the Health Leads complex only contains 200mcg of folate. Is it safe to take the 400mcg of folate and the extra 200mcg in the Complex ? My seeking Health 5000mcg methyl /adenosyl sublingual I take every couple of days. So the fact that the Health Leads B complex only contains 200mcg is not a concern. Thanks so much
I would be inclined to alternate the folate supplement with the B complex every other day , and see how you feel? Time Health Supplements do an excellent b complex too, again with no nasty fillers and additives( Very good UK company, but not cheap, although discounts and free postage) . I am inclined to agree that a b complex is a very good idea.Many people on this forum have suggested a full multivitamin is possibly less helpful, and it certainly was unhelpful in my case, as it did not appear to keep my folate levels high enough. I just checked back and some bloods I had taken in April indicate my folate was at around 11. On a previous post on this forum, somebody suggested 18 is the optimum folate level to aim for, and based on my symptoms returning, this sounds correct to me.
I can honestly say I feel so improved again with the individual folate, and I can't believe I missed what was happening . Hope it goes well for you Lynne x
Thank you. I shall do as you suggest. Alternate the Folate and the Complex and see how I get on. My Homocysteine blood test also showed that it had raised massively. It is 14.1 (abnormal high) Previous blood test showed a level of 9.9 which is just within range with a folate of 8. I hadn't realised 8 was too low as within normal range. I know B12 and folate are responsible for getting rid of the homocysteine in the methylation process. and that 9.9 was far too high. Should be as low as 7 even 6. When I very first had my homocysteine serum tested it was 9.9 which is when suffering symptoms I started to take B12 into my own hands (due to inertia of GP) and take sublingual B12. The following annual blood test, homocysteine had reduced to 8 which I was very pleased about. I was unaware then of the need for higher folate levels.
I still dont know why I have become deficient in folate. I remember it being 20 the year before it was 8. and I just thought it fluctuated. Diet is obviously not enough though. As it is obvious that the low folate/deficiency has been the cause of my homocysteine rise I do know that a homocysteine serum level of near 10 or over means high risk for heart disease/attack and memory problems, dementia/alzheimers which noone wants
I first learned about the effect of homocysteine from the website Food for the Brain. And Dr Malcolm Kendrick in his inimitable style wrote about the positive research conclusions of taking B vitamins and the dismissive attitude because of pharma interference. If interested in reading drmalcolmkendrick.org/2021/...
Thanks Lynne, I will have a read of this , looks very interesting. My own humble opinion is that big pharma has become almost completely detrimental to our health and being well. I made the decision a few years ago, along with my husband, that we had to take responsibility for our own health, and avoid medications as much as possible. And this as someone who worked for the NHS for 15 years. There is no money for big pharma in patients getting well. Sounds to me like you are on a very positive path to great health.
Thank you. I hope you enjoy the article. Dr Malcolm Kendrick researched for years to determine the real cause of heart disease (hint-nothing to do with cholesterol) He wrote his book 'The Clot Thickens' a couple of years ago, determining the real cause. He does not leave you stuck with a feeling of being a lost cause but advises what to do and what supplements to take to address, which is brilliant. I can thoroughly recommend it. He has a great sarcastic style which make his books enjoyable to read. x
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just a typo. Please have your GP request a blood test for homocysteine. I always have homocysteine checked in my blood tests (NHS) You just need to phone your nearest hospital phlebothamy dept (or further afield) to make sure they can test for homocysteine in their labs as has to be in the labs within half hour to an hour from being drawn.
B12 and folate up but ferritin down
Serious memory loss - do I have B12 deficiency or PA?
B12 deficiency - it’s official! What next?
Folate levels
B12 deficiency, injections and blood test results
