I do know its important to supplement with folate if your taking B12, as it can mask a deficiency.
I think you have that slightly muddled up.
If someone has low B12 they often end up with macrocytosis (abnormally large red blood cells). This shows up in blood testing with high MCV (Mean Corpuscular Volume).
So a doctor who sees high MCV knows that they need to check B12 levels.
However, if someone who has high MCV (but doesn't know it) starts supplementing folate before any testing is done this can reduce the degree of macrocytosis and this therefore masks B12 deficiency (and so the doctor doesn't test B12).
The way round this issue is to make sure that both B12 and folate are tested before supplementing. Then supplement B12 and/or folate appropriately based on the results.
I am not sure if this says anything but my MCV is normal. What I do have though is increased RBC, PDW, MPV and P-LCR, along with the folate deficiency.
and maybe ask your GP to test for B12 deficiency and Pernicious Anaemia.
Do not supplement with folic acid/methylfolate or a B Complex for the low Folate until further testing of B12 has been carried out, it will ask signs of B12 deficiency and skew results. Supplementing for low Folate is started after B12 injections or supplements have been started.
Hidden I don't take any B12 supplement. As I said, it is within range and no doctor told me to supplement. Thanks for the info though!
SeasideSusie thanks for the info. However as I said, I am not B12 deficient (though on the low end). Truth is, my B12 flunctuates a lot but is within range. The result I posted is the lowest I have ever seen). And since I know that I am ok with B12 do you still think that I shouldn't supplement with folate yet?
"However as I said, I am not B12 deficient (though on the low end)."
B12 deficiency is diagnosed by symptoms (or should be) not numbers. As I said, many people with a level in the 300s have been found to need B12 injections. You have Folate deficiency and 3 symptoms of possible B12 deficiency, have you checked the link I posted to see if you have any more?
I have checked the link with the symptoms, and as expected I have a lot of them. Almost all neurological and vascular symptoms.
However to my understanding these symptoms overlap with thyroiditis symptoms, so I imagined that they were caused by thyroid. How can I know whether they are caused by thyroiditis or B12 deficiency if I am within Lab range?
"As I said, B12 deficiency should be diagnosed by symptoms not numbers."
I agree with you. What I am asking is how can I understand which symptoms are B12 caused and which are thyroid? And before you answer, I know you most probably aren't a doctor, so I am not pushing for a diagnosis, I just would like your opinion on it since you most probably have seen much more related posts that I have.
"List the symptoms of B12 deficiency and ask your GP to test for B12 deficiency and pernicious anaemia."
I will though this will most probably not help at all; you know how doctors are, if you are within range, you are ok and no test is required. Do you know if there are any more tests on anemia other than blood? As I mentioned earlier, i have increased RBC, PDW, MPV and P-LCR, along with the folate deficiency. And my doctor never even mentioned this, I just happened to look at my results and saw it.
"You could list them on the PA forum here on HealthUnlocked for their comments"
List all your symptoms that you have said are in that list I linked to in your post on the PA forum. Symptoms are important for diagnosis of B12 deficiency.
There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms,
Patients with AITD have a high prevalence of B12 deficiency and particularly of pernicious anemia. The evaluation of B12 deficiency can be simplified by measuring fasting serum gastrin and, if elevated, referring the patient for gastroscopy.
Levothyroxine can decrease serum homocysteine level partly; still its combination with folic acid empowers the effect. Combination therapy declines serum homocysteine level more successfully.
I sympathise. I have both conditions. Hypothyroidism is often linked with low B12. The thing about supplementing with B12 is that you will know if it is as your symptoms will improve. Treating b12 deficiency doesn't mean you cant treat hypothyroidism.
You say you have had to push your doc hard for your present level of levothyroxine and in truth you could definately benifit from a further increase. Whilst youre battling that one out get him to look at your B12 and see if he will let you have injections because of your neurological symptoms. This should allow you an injection every other day until no further improvement.
Many people do not have the macrocystosis as its a 'late' symptom but its wise to rule it out.
A word of warning though my GP was relunctant to prescribe b12 injections as my b12 level was also very low but in range. She insisted I saw a neurologist. I decided to inject before then as it was a long wait. My blood count etc was fine. Many of us with b12 deficiency end up having to self inject & get our own b12 vials........its rather simular to the thyroid world lol.
More people will see your request if you make your own thread, tacking it on to someone else's means very few people see it.
If you are taking B12 it's a B Complex you need, not just folate alone. When taking B12 you need to keep all the B vitamins in balance which a B Complex will do.
Make your own thread and post all your vitamin results with reference ranges for suggestions specific to your own needs.
If you're taking Vit D supplement there are cofactors that are needed, are you taking them too?
Yes. and thank you for your reply...was taking menopace suppliment for all vitamins but didnt help...thought I would try individual vits .high dose..last blood test showed vits good but doctor didnt give me printout just that they were good and T4 and T3 normal..they were normal all through this sorry scenario even though I felt like I was dying!!,endo nurse said they cant treat what they cant see...I came home and cried!!and decided I would do all myself including supplimenting vits...but cant find folate to take alongside B12 and VitD.and slowly evaluate situation myself..seeing Endo end of month and see what he has got to say..think levo itself is my problem with side effects from vision/eye problems to wobbliness.anxiety and palpatations at night in bed...small ones in day too
As I said, please start your own thread to discuss your own situation rather than piggyback on someone else's, your question wont be seen by people who may be able to help you and it's not really fair on the member who started this thread to take it off topic.
If you haven't got results of your tests, ask at your GP surgery's reception desk for a print out (it's our legal right here in the UK to have them, don't accept verbal or hand written results, get a print out), then post results, reference ranges and all relevant information, including what supplements you are currently taking, in a new thread of your own and you will get replies specific to you.
When I had my folate 2.24 ug/L (range 3.89-19.45) I had frequent palpitations I also had low erythrocytes (red blood cells), I guess this somehow connected with folate deficiency and probably lightheadedness too if your red blood cells are low too. My vit 12 was in mid range. As soon as I started taking folate supplement (just a cheap one from supermarket) palpitations have stopped within a week or so, I was taking 2 a day and after 6 months it has increased to 16.1 ug/L. Take it with magnesium, it did give me headaches when taking alone. Also magnesium can help with anxiety too. So yes, from my experience folate deficiency can definitely cause palpitations.
It is sure that folate deficiency such as yours can cause such symptoms. What I asked though is if even a borderline deficiency can cause it. And more mind boggling is that my red blood cells are actually increased not low.
It’s my pleasure, I’m happy if I could help in any way. I think borderline deficiency can well cause palpitations as well. My palpitations didn’t stop right away, it took about a week or so to settle and I was taking 1000% RDA dose (2 folic acid tablets plus from multivitamins). Yes that’s confusing that your RBC are increased, I thought low folate will always result in low RBC. I hope you’ll get it sorted soon xx
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