I have PA and lots of B12 injections. My folate in blood is 6 recently. It used to be higher. Dr said take folic acid to get it up a bit. Is that a good idea? Does the folate trap affect those getting lots of B12 injections? I don’t fully understand it but I’ve read folic acid can block receptors which absorb B12
Alternative is to take methylfolate but had a really bad experience with this giving me out of the park anxiety in the past and prior to that I hadn’t ever suffered anxiety in 50 plus years. Maybe a tiny dose of methyl folate?
I’m trying to eat folate rich foods. Is that likely to work does anyone know?
Would really appreciate advice and insight on this
Thank you
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Blais
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Yes a good idea. As long as B12 is treated first its fine tk take folic acid.I took 400mcg daily after my b12 injrctions and folate level soon went up .
I need a lower maintenence dose .
We are all different .
Of folate is supplemented when a person has untreated B12 deficiency it can mask the deficiency and therefore cause nerve damage ect .
Taking folate before b12 doesn't cause nerve damage. Not taking b12 if low can cause nerve damage. I had b12 of 176 and had zero symptoms. Masking symptoms doesn't cause nerve damage. Not taking b12 during a deficiency does.
That's not what I'm saying. I'm saying taking folate does not cause nerve damage. You need folate to properly absorb b12. So if you start b12 first with a folate deficiency you can end up with lower folate and lower b12.
You always supplement folate first if you have a folate deficiency. If you don't then when you do take b12, b12 won't be accessible so your b12 won't have enough folate it will lower folate and b12 won't raise.
Theres no reason that folate trap would still occur with provision of adequate B12. In terms of folic acid blocking B12 I think there is low quality evidence for this but as far as I'm concerned its a reason to be cautious with megadosing folic acid in the absence of clear deficiency. If methylfolate does not suit you, folinic acid is a non methylated alternative. Folate in foods should be just as effective, plus you get the benefits of high folate foods which are generally healthy plant foods.
The hypothesis relating to high intakes of folic acid impacting active B12:
"Based on the evidence presented above, we propose that “the high-folate–low-vitamin B-12 interaction” represents a genuine cause of vitamin B-12 depletion. We hypothesize that this is the consequence of excessive intake of folic acid (rather than merely exposure to high folate status) that results in a specific decrease in the active form of the transportable vitamin B-12 in serum, holoTC. In vitamin B-12 deficiency, this decrease in holoTC concentration would further compromise the availability of vitamin B-12 coenzymes for enzyme action, and consequently exacerbate the deficiency. Moreover, we hypothesize that this effect is specific to oral folic acid, which, when consumed in a high-enough dose, will enter the circulation and selectively bind to tissues expressing the high affinity folate receptor (FR-α). This, in turn, leads to sequestration of holoTC in hematopoietic tissue and altered reabsorption in the kidney. "
Yes, and this may be because folic acid is completely synthetic and does not exist in nature. It does bind up the receptors and takes much more work (400x?) for your body to process in order to extract a small amount of useable folate. They have recently mandated its addition to flour here in NZ - like they have done for years in the US. It is not effective at preventing neural tube defects, which is the proposed benefit, as it is the wrong thing/form anyway.
Before diagnosis, my folate was over the top of range - more than 24. I assumed that once I had topped up on B12 jabs, that it would go down. It never did. I now don't supplement at all and its still above the high limit. As Nackapan says, we're all different, either that, or I'm just an odd old bird 😜
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