Folate and B12 levels recent blood test results

[skylark25]

Hi everyone,

I'd be most grateful for your thoughts on blood test results received yesterday,

The background to my query: I have PA, diagnosed 18 months ago, and a number of other health conditions, including autoimmune hypothyroidism and connective tissue disorder. I have been receiving B12 injections, at 3 monthly intervals initially, adjusted by GP to 2 monthly after neurological symptoms were acknowledged.

Because of return of symptoms (ocular migraine attacks -- absent for over a year -- and balance difficulties) I have recently started having a B12 jab at local pharmacy to increase injection frequency rate to four weekly intervals. Because this regime has not had the desired effect, I asked for my folate levels to be checked. Results:

23-Apr-2024 ! B12/folate level - (CS1216) - B12 levels actually above normal range - could consider reducing injections to 3monthly if wishes..

! Serum vitamin B12 >1107 pmol/L 133.00 - 675.00pmol/L

Serum folate 5.1 ug/L 3.10 - 19.90ug/L

I'm aware that there is little point in checking serum B12 levels once on B12 injections and did not request this. I hope I won't have to battle with GP over the suggestion of reducing the dose...

My take on the results are that folate is low, although not outside stated 'normal' range. I have decided to take folic acid. Thoughts on that and brand recommendations and dosage would be much appreciated. Because my diet is rich in folate, should I ask to be tested for coeliac disease? Also, the discrepancy between the 2 B vitamin levels seems large. Is that likely to be significant?

[Nackapan]

All women of chikd bearing age ard recommended to take 400mcg folic acid daily..My level f Holgate was lower asd responded very quickly to that dose.

Multivits usually contain 200-400mcg .

I personally don't think thr brand matters .

As fof thr b12 levels your G.p dhoukd know its meaningless to test on injections.

The level shoukd be high.

Get them to read their guidelines.

The new NICE guidelines may help with this .

A specialist should support thd frequency you need.

It was a neurologist who did for me .

2 out of 4 did .

[skylark25 in reply to Nackapan]

Thanks for this helpful and speedy response, Nackapan. I will start taking folic acid and report back on the outcome. If my GP suggests reducing B12 jab frequency, I may well seek an appointment with a neurologist.

[Orchard33 in reply to skylark25]

You could have an active B12 test which will tell you what your cell level/usable B12 is. I'm planning to do this in the next month or so. I inject EOD so the serum B12 level is off the scale. Which means very little if there is impaired absorption.

[bookish in reply to Orchard33]

Your active B12 may also look perfectly ok and you still not be able to absorb or metabolise. All tests can be normal, as I'm sure you know. Cheers

[Orchard33 in reply to bookish]

I didn't know that. It rather demolishes any faith I have in tests! Symptoms, symptoms, symptoms.

[bookish in reply to Orchard33]

All of the tests can give clues and can even show a frank deficiency - some people are low in serum, some low in active, some show with antibodies, some with anaemia and methylmalonic acid or homocysteine....but at the end of the day, symptoms, history, family history (as metabolism is strongly genetic and epigenetic) have to be front and centre if the tests don't tie up with the reality.

[bookish in reply to skylark25]

See how you get on with the folic, which suits most people but not all. Some do better with folinic or methylfolate (like me). Hopefully your GP will ignore the nonsensical comment regarding B12 frequency. Best wishes

[skylark25]

Thanks for your thoughtful responses, Orchard and Bookish. Excuse brevity, I am having to avoid screens because they trigger scintillating scotomas.

[bookish in reply to skylark25]

Sorry, missed the coeliac bit - yes if not already tested it is always a good idea, especially with other autoimmunity, but like B12 and thyroid testing, nothing definite about it as it can miss people (and you might be non-coeliac gluten sensitive anyway). You need to be eating plenty of wheat gluten, but if you are already off gluten and getting benefit, don't go back on for testing as it will just cause more damage. Best wishes