low folate and panic attacks

[irisflower2001]

i’ve started having awful panic attacks again. they are debilitating! i got put on fluoxetine which only made things worse! i then had a blood test and my folate is at 2! in 2021 i was found to have a b12 deficiency. i also had panic attacks when my b12 was low. i’ve since been having injections every 3 months. i’m looking for some advice on the folate. i’ve been prescribed 5mg folic acid for 3 months. when will i feel better / stop having these panic attacks. they are making me so so so so sad.

[Chalkitup]

Since you had panic attacks when low on B12 previously it makes sense that you are also having panic attacks with normal B12 but low folate. Our body needs folate in order to utilise B12 within the body. So with low folate it's also acting like you have low B12 as the body cannot access the B12 that's in the blood properly. Hope this makes sense.

Hope you feel better soon.

[Nackapan]

Sounds like you need a higher frequency of b12cand after a loading dose of folic acid a maintenence dose of 400mcg folic acid daily Panic attacks horrid and should go away with more B12 and maintaining Folate levels

On your next blood test include ferritin and vitamin D

[BirdlessBox]

You may be one of the people who are not able to process Folic Acid. Try changing to Methyl Folate and see if that helps. With Methyl Folate you can also take a higher dose which is not advisable with Folic Acid.

[Oneash]

B12 injections every 3 months is probably not enough. I take Igennus Healthcare Super B-Complex because it contains all the Bs in their most absorbant forms. I also take vitamin D, and DHA omega 3 rich fish oil and zinc for building brain and nerve myelin.

Have you had a Pernicious Anemia diagnosis?

[Cherylclaire Forum Support]

Sorry to hear you are having problems with anxiety.

You might need more frequent B12 injections than 1 every 3 months.

Initially, I was given B12 injections at this frequency, then later as my symptoms continued, folate and ferritin being low within range, I was given 3 months of supplements of both. I found that my folate and ferritin took about two years to settle down - and even now, I can get low in either/both. My folate was never as low as yours has become: 5.5 at worst. Ferritin was, at worst, 36 but can cause deficiency symptoms if less than 60, according to my GP. Both went up and dow erratically. Vitamin D I get on prescription, as I was found to have osteoporosis of the spine - so get this checked too. Thyroid can struggle with all this going on and also worth checking.

All four of these should be monitored, especially initially. It helps both you and your GP to know the full story !

B12 is a difficult one - once you are having injections, it is not advised that your levels are checked. This can only reveal how much total B12 is in your blood - and not whether it is active or inactive B12, or whether it is able to reach the cells and tissues effectively.

I would say that a good observant GP, one who is already aware of your particular set of symptoms, would be more likely to check with you about return of B12 deficiency symptoms than trying to gauge your serum B12 level as a measure of successful treatment. They might want to check if your MMA level is raised or high, which could indicate if there is a functional problem with the B12 - but this particular blood test is not easy to access at primary care level and other causes for this need to be eliminated. They might want to get an active B12 test - again, not easy from primary care so a referral to secondary care (haematology probably) might be the route, but will involve a wait.

An increased B12 injection frequency trial might be an easier way to decide whether this would help you get rid of symptoms more effectively. Do you think your GP might agree to a trial ?

Has anything else changed since your anxiety returned ? Your energy levels more depleted by having to work harder for instance ? Additional stress, mental or physical, or any illness (covid or flu for example) can affect your progress.

Wishing you well and hoping that the folate supplement helps. Your folate level was very low.