Folate query: Hello evening people I have noticed... - Thyroid UK

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Folate query

smilingjane
smilingjane

Hello evening people

I have noticed in a couple of posts today that it seems to be important to get B vits with folate but not folic acid.

Wondering why? and also is Ferritin the same as Folate?

Many thanks .....

84 Replies
oldestnewest

Ferritin is your iron stores and folate, I believe is the natural version of folic acid but I don’t know enough to answer your first question. Hopefully someone more knowledgeable will be able to help you with that 😊

smilingjane
smilingjane
in reply to Samd39

Thank you :)

Ferritin is iron stored in the liver as a protein.

Folic Acid can be an issue around absorption as it is synthetic - can also affect methylation. Folate is more natural. Folic Acid is cheaper and can work for many. Folic Acid is also called B9 ...

smilingjane
smilingjane
in reply to Marz

Thank you Marz :)

helvella
helvellaAdministrator
in reply to Marz

Certainly ferritin is stored in the liver but there is quite a lot in blood!

I agree with you, and am not at all convinced that, with low doses such as 400 micrograms a day, it makes much difference whether we take folic acid or folate. For some, it might make a difference.

Hummm .... more to digest, thank you!

Marz
Marz
in reply to helvella

Yes of course ! - I wanted to add - and can be supplied on demand ! Ferritin that is 😎

Treepie
Treepie
in reply to helvella

I have had high ferritin for some years but does this mean I should reduce iron intake in food? Not that I eat liver.

helvella
helvellaAdministrator
in reply to Treepie

Do you have haemochromatosis?

haemochromatosis.org.uk/

Iron is a complicated subject. Too much can have lots of effects. But ferritin alone is not sufficient to guide decisions and treatment. Yes, very low ferritin seems always to be something that needs addressing but, beyond that, it is not simple.

This site has a lot to wade through:

irondisorders.org/

Sorry but I simply do not feel I know enough to provide any explicit guidance. :-(

Treepie
Treepie
in reply to helvella

No to haemochromatosis, ferritin got over 900 ,when last tested over 700 but haematologist thought not a problem .Mind you he was treating me for lymphoma and I have Barratts so might be sign of various inflammatory conditions. Thanks for the link.

vocalEK
vocalEK
in reply to Treepie

High ferritin with normal iron numbers can be caused by inflammation. I suspect the lymphoma was the cause of your high ferritin test result.

Treepie
Treepie
in reply to vocalEK

I thought so but was high after the chemo finished but I also have Barratts oesophagus so maybe that is a factor.

galathea
galathea
in reply to Marz

Folic acid has to be converted to something else to be of use. I have a defective mthfrc677c gene which means i cannot use or convert folic acid. Methyl folate doesnt have to be converted and is ok if you have the defective gene.

Marz
Marz
in reply to galathea

Absolutely ... hence I mentioned methylation above 🤔 Have you always known you have a faulty gene ? How does it affect your health ?

galathea
galathea
in reply to Marz

Marz, i had my 23 and me gene profile done . Thenabout a year aho i went to get tests at the docs because i was tired and fat and couldnt get myself right. Turned out i had folate level of 2. This can cause diabetic symptoms, fatigue etc. I checked the 23 and me raw data and found i had the defective gene. I took methyl folate ANd felt tons better after about 4 months. Have list just over 2 stones with no effort. Whoo hoo! am still Supplimenting methyl folate.

Marz
Marz
in reply to galathea

So good you already had the genetic testing to support your low Folate. Congrats on the weightloss - hope you are feeling well. Thanks for replying ...

SlowDragon
SlowDragonAdministrator

It’s relatively common, especially with thyroid disease to have MTHFR gene variation.....there are many mixes of MTHFR gene issues

healthline.com/health/mthfr...

Folic acid is more difficult to process than folate

chriskresser.com/folate-vs-...

More to learn and try to remember. thank you Snow Dragon 😊

yesendi
yesendi
in reply to smilingjane

That's is right, folic acid is the synthetic form of folate which folate comes from real food and folic acid is man made and dangerous for your health.

SlowDragon
SlowDragonAdministrator
in reply to smilingjane

Just read your profile

Are you supplementing magnesium for restless legs

What’s your vitamin D level?

I haven`t an up to date D blood result.

A year ago it was 9. Not sure about the range. I supplemented for around 6 months and it rose to a much higher level not sure what.

Recently after reading about D I have been taking powdered capsule 2200 per day, (taken at night).

I also take an all in one capsule containing:

Magnesium (4000mg) ,

Zinc, (15mg)

Calcium, (1000 mg)

Also the 100 B vits thing which I am thinking of stopping for a while after stuff read on the site. Maybe , not sure.

I am 2 months into these vits. I still have bone and muscle aches which vary in different place in my legs, except the bone pain which is just down the right leg splint bone.

I am wondering whether to stop the vitamins. I plan to make an appointment with a privet endo suggested by another member on this site. Do you think I should do this to reveal `true` results?

I have just started the Selenium, (the one thats more easily absorbed in the gut).

Thank you Slowdragon

SlowDragon
SlowDragonAdministrator
in reply to smilingjane

Strongly recommend getting vitamin D retested

If it was 9 that’s EXTREMELY low

Presumably you were prescribed LOADING dose by GP. That’s 300,000iu over 6-8 weeks.

ouh.nhs.uk/osteoporosis/use...

You should have had vitamin D retested at end of the course and been advised that you will need to supplement continuously to maintain levels

NHS postal kit -£29:

vitamindtest.org.uk

GP will only prescribe to bring levels to 50nmol.

But improving Vitamin D to around 80nmol or 100nmol may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

I had excruciating bone pain when first started vitamin D supplements.....after decades of being very deficient....It slowly faded after 4-6 months as levels improved.i now keep my vitamin D roughly around 100nmol. As maintenance dose I need 3000iu per day

Every person is different on how much they need ....that’s important to test vitamin D twice year

Bone pain may be due to bones remineralising

easy-immune-health.com/pain...

Magnesium is important co factor

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

intechopen.com/books/cell-s...

If vitamin D is low, B vitamins may be too. As explained by Dr Gominack

drgominak.com/sleep/vitamin...

Great video

healthunlocked.com/thyroidu...

SlowDragon
SlowDragonAdministrator
in reply to smilingjane

BEFORE Considering seeing any endocrinologist we would ALWAYS recommend getting FULL thyroid and vitamin testing first

Ideally all four vitamins need to be optimal before seeing endo

SlowDragon
SlowDragonAdministrator
in reply to smilingjane

as you have hashimoto’s.....Are you on strictly gluten free diet?

Or tried it

Hi

On off with Gluten. I will have to start and be strict..

I wasn't told by the GP about continuing with D sups. (at least I cant remember). But am aware now and am going to get the oral D along with the K2 Mark 3 (Does it matter f it dosn`t say Mark 3?) I will ask for a D test too.

Thinking about the tests to ask my GP for will you remind me with a list again please? And also do you think it would be wise or unwise to mention that I want to take them to a private Endo?

Many thanks for getting back to me to help. It is really appreciated.

I hope you are having a good and cosy weekend.

Jane

Thank you for all of those links by the way. Very thoughtful :)

SlowDragon
SlowDragonAdministrator
in reply to smilingjane

Gluten free diet has to be absolutely strictly gluten free to be effective

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten intolerance. Second most common is lactose intolerance

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying strictly gluten free diet for 3-6 months

If no noticeable improvement, reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Wondering, does it matter to bother testing for Ceoliac if I am going gluten free anyway?

SlowDragon
SlowDragonAdministrator
in reply to smilingjane

If already on low gluten diet there’s probably little point

You would have to eat high gluten for 6 weeks before testing. Gluten at all three meals

also, sorry if you have already answered this, cant see it .... would you recommend keeping off all vitamins untll I get my bloods done with the GP. And how long does it take to get the B vits out the system?

SlowDragon
SlowDragonAdministrator
in reply to smilingjane

GP’s budget won’t allow testing vitamin D more than once a year

Better You make one that includes vitamin K2 (Cheap on Amazon)

betteryou.com/vitamin-d-k2

Suggest you double check EXACTLY how low it was when diagnosed by looking at old test results

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

BEFORE seeing any Thyroid specialist endocrinologist

Need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or retest vitamins

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Have you got the list of recommended thyroid specialist endocrinologists from Dionne at Thyroid UK?

thyroiduk.org/tuk/About_Us/...

Most endocrinologists are diabetes specialists and hopeless for hashimoto’s

Why is this I wonder? Is it that its just flippen complicated?

also, sorry if you have already answered this, cant see it .... would you recommend keeping off all vitamins untill I get my bloods done with the GP. And how long does it take to get the B vits out the system?

SlowDragon
SlowDragonAdministrator
in reply to smilingjane

Don’t stop vitamin D. Just stop day before blood test

B vitamins. If supplementing a vitamin B complex, or any supplements that contain biotin, need to stop a week before ANY blood test as biotin can falsely affect test results

You would need to be off B12 for 4-6 months to get base level of B12

If supplementing iron, and wanting to know iron levels, then you need to stop this one week before test

Thank you so much Slowdragon. You have been a fantastic help in my quest to know.

Hope your having a good weekend.

😊

Yes I have Dionnes list. :)

smilingjane
smilingjane
in reply to BadHare

Very interesting 🤔

It us claimed in various places that people getting b12 injections need folic acid or folate supplements. I've been self injecting hydroxocobalamin twice a week for a long time and my folate levels were fine at last medichecks test a couple of weeks ago.

Is Hidroxo ....... a folate injection and do you take B12?

What do levels need to be before B12 needs supplementing?

helvella
helvellaAdministrator
in reply to smilingjane

Hydroxocobalamin is one form (a vitamer) of B12.

For B12 issues, I usually suggest going onto the Pernicious Anaemia Society forum, here:

healthunlocked.com/pasoc

Pernicious Anaemia is where the body is unable to absorb B12. They know a lot about it!

The trouble with supplementing now is if you do so, you might not get diagnosed with B12 absorption problems and, without that diagnosis, you are unlikely to get any injections of B12. If you need injections, tablets are inadequate.

Ahh right .... I supplement B bits (Solgar) - and my levels are high in the range. So you are saying taking the USPS wouldn't make a difference if I was deficient? Ir am I misunderstanding?

helvella
helvellaAdministrator
in reply to smilingjane

What I am saying is that B12 is different to all the others.

There is a complex process by which B12 is absorbed from the gut. If any of that goes wrong, your absorption can be affected.

In a healthy person, there is an entero-hepatic recirculation of B12. That is, once used, it is collected from the blood and ejected into the gut to be re-absorbed. That too will not function correctly.

But diagnosis of B12 deficiency, specifically the impaired absorption, is not easy. If you are taking B12 and any is being absorbed, you are unlikely to get a diagnosis.

Further, taking folate or folic acid will correct one of the key signs doctors use to establish B12 deficiency. Macrocytosis - or enlarged red blood cells. Having sufficient folate OR B12 resolves that specific issue but not all the other problems B12 deficiency causes.

BadHare
BadHare
in reply to helvella

Interesting! 🤗

Sorry I meant sups 😊

helvella
helvellaAdministrator
in reply to smilingjane

Took a moment but I did read it like that.

You may not realise that you can edit, or delete, any posts or responses you have made here.

HealthUnlocked have produced some help for how to do this. You can find this here:

support.healthunlocked.com/...

When you edit the original post in a thread, you will also have the option to add (or remove) a single image. (To replace an image, remove the existing image, then add the new one.) This is the same process as writing a new post:

support.healthunlocked.com/...

I am pointing this out purely to ensure that you know your options. :-)

(If you make extensive changes, it is sometimes helpful to add a comment so that people can see that you have made changes.)

Thank you Helvella, that is really helpful 😊

BadHare
BadHare
in reply to helvella

That was my issue. GP didn’t tell me to stop supplements prior to either deficiency blood tests, though I’d not have benefited much from meagre quarterly injections that my friend with PA gets.

BadHare
BadHare
in reply to Scothyroidy

I read somewhere low folate can cause permanent neurological damage if B12 is taken with low folate. I have good dietary intake & take B complex or use nutritional yeast.

helvella
helvellaAdministrator
in reply to BadHare

Taking folate/folic acid with inadequate B12 certainly can be an issue.

Lovecake
Lovecake
in reply to helvella

The first time I had folate (and more) checked, the lab put a note to say do not supplement with folic acid if B12 is low as it can cause issues with the spinal chord.

Needless to say, my GP just gave me folic acid tablets......

My B12 was pretty low but not under range, I just supplemented with both. (I didn’t know about PA back then).

I cannot tolerate cheap folic acid, it gives me headaches.

Methyl folate with a B complex works for me.

Mermaid238
Mermaid238
in reply to Lovecake

I don't think these American doctors care enough to know what vitamins do to the body - how do you get someone who knows this stuff

Lovecake
Lovecake
in reply to Mermaid238

I read posts and answers on this site and follow as much advice as possible. If left to a GP I’d be struggling big time.

Mermaid238
Mermaid238
in reply to Lovecake

I take Mega B 50 Solgar and a separate 1000.00 mg B/12 Methalcobalamine

Taking a B50 supplement is not a good idea - it can backfire on you badly.

The B50 supplements are just a marketing product that sounds good in advertising - include 50mcg or 50mg of everything related to B vitamins, and isn't it lovely that is sounds nice and neat - but the body doesn't work like that. It doesn't need vitamins in multiples of 50mcg or 50mg, and in some cases it is a massive overdose.

Most B vitamins are excreted by the body if taken in excess, so people usually do okay. The big problem is vitamin B6.

Vitamin B6 can cause symptoms in deficiency but can also cause toxicity problems. If the symptoms of B6 toxicity aren't recognised promptly and supplementation of anything containing B6 isn't stopped then the symptoms can become permanent.

Unfortunately neuropathy is a symptom of both deficiency AND toxicity, so realising there is a problem may take some time.

Deficiency : en.wikipedia.org/wiki/Vitam...

Toxicity : en.wikipedia.org/wiki/Vitam...

I actually got caught by this issue about 10 years ago, a few years before I developed an interest in optimising nutrients and treating the thyroid.

I had various symptoms that suggested I was short of a few different B vitamins. Peripheral neuropathy was one of those symptoms. I started taking a B100 product (1 bottle) then reduced to a B50 product.

My symptoms of peripheral neuropathy reduced to begin with, I had about 3 - 4 months of feeling better than before, then the pain started getting worse again, very rapidly. Luckily I did some research into the problem and discovered the issue with vitamin B6 and stopped taking the B Complex I was taking. Luckily the neuropathy did recede. I didn't take B Complex at all for several years.

I do take a B Complex now, but I only take supplements with a fairly modest amount of B6. And I do take holidays from taking B Complex quite regularly. I do have issues with sore legs and feet now, but I'm not sure if that is because I'm getting old, don't do enough exercise, or whether it is related to damage I may have caused by taking vast amounts of B6 ten years ago.

I actually don' take them every day. What do you uggest in the B's. What about the b/1 I take in the form of Methlcobalmine? I also take Magnesium citrate 200 mg sometimes Thysilyn - C 1000 mg Co Q 10 100 mg Selenium Garlique

I think B6 is the only thing in a B supplement that can cause toxicity issues.

Magnesium citrate at 200mg per day is absolutely fine for anyone with reasonably healthy kidneys. I take roughly double that, and I take magnesium almost every day - without it I get cramp in my feet and legs. Magnesium is only a problem in people with very poor kidney function - in that situation magnesium may build up in the body and cause problems. Kidneys that function adequately will excrete excess magnesium.

Vitamin C at 1000mg is fine. Lots of people take lots more.

Co-Q10 and selenium - I haven't investigated the benefits or dangers of these and don't know what the safe upper limit is. I take both and just take the dosage given on the bottle.

Please be aware that I'm not a doctor and have absolutely no medical training.

O know - but the people who research as I have in the past know more than some doctors about vitamins - I am 85 I have a low GFR Just recovering from hip fracture in September - walking wit cane - some getting over I tell you. I also have Hemiplegic migraine - in 2007 I had strokes connected with PFO and migraine Hole in the heart. I had been taking Vit E for years - stopped cold turkey when I had a perforated appendix at 70. The antibiotics were so brutal I stopped all vitamins

The problem for people with kidney failure or extremely poor kidney function is that magnesium may build up in the blood if supplemented, (functioning kidneys will excrete excess magnesium) and this condition has plenty of unpleasant symptoms.

But having too little magnesium is also very unpleasant.

How people with poor kidney function find the happy medium is something I don't know.

Too much magnesium : en.wikipedia.org/wiki/Hyper...

Too little magnesium : en.wikipedia.org/wiki/Magne...

One thing to be aware of when testing magnesium (or if your doctor tests it)...

Only about 1% of the body's magnesium is held in the blood stream. The other 99% is found in bones, muscles, organs etc. When the level of magnesium in blood drops too low the body will take magnesium from other tissues and move it into the blood stream. So magnesium in blood can look perfectly fine while the body is possibly severely deficient.

What this means is that the magnesium test is fairly useless. But doctors still do them anyway.

Lovecake
Lovecake
in reply to Mermaid238

Just want to say I think you are doing brilliantly.

My mum is 82 and refuses to use a pc or anything other than a base mobile.

Sorry if it’s off topic, just felt you needed a pat on the back. (And I do know many other people over 80 and 90 do).

Hope you recover well from your OP. 🤗

Mermaid238
Mermaid238
in reply to Lovecake

Well thank you how sweet -- I am still working I own a modeling agency - I I use a PC and so called smart phone - I find it not so smart at times. LOL I have always been very active until I fractured my hip in September - really set me back.

Are you from UK? I was born in UK I live inMiami now

Lovecake
Lovecake
in reply to Mermaid238

UK. Always. Never been to the States. Maybe one day. But not unless things get a huge amount better with my health. Just haven’t got the energy for all that travel/sleep loss.

Just need enough energy for my family and new grandson. And that makes me very happy if I can be there for them.

You’ve given me huge inspiration to never give up. Thank you. ☺️

Mermaid238
Mermaid238
in reply to Lovecake

Ih please don't ever give up - you can contribute a lot. Healthis terrible though if it is not good. I know I feel a huge set back with this hip I started driving again last week - have to get another car mine is too low it is a Seabring sports model. Now I have to get a granny car LOL Just so long as I can drive I don't care what it is - do you have other than the thyroid issues.

Lovecake
Lovecake
in reply to Mermaid238

Hashimotos and migraines. The migraines are my body’s way of telling me there’s something wrong. But it’s taken me many years to realise this. Drs have been no help. I’m miles better, and determined to improve more.

My husband has been ill for a long time with things I won’t go into. I think this has impacted on my health. But now I have more good days than bad and I’m forever grateful I found this forum.

Just been reading to my grandson, am sure he thinks I’m a crazy grandma, but he’ll get used to me (he’s only 3 months).

Enjoy your driving and freedom ☺️

Mermaid238
Mermaid238
in reply to Lovecake

He loves it I am sure - take care been loving chatting. You made me feel good

Humanbean, Stasha Gominak concluded that pantothenic acid (B5 I think) could also be toxic, contrary to received wisdom: drgominak.com

Do you have a link to her comments on B5? I'm not familiar with her at all.

I'm afraid I have no idea how to post a link on my phone! 😟

But if you find her website (drgominak.com) and select the menu bar, go to "for clinicians" and scroll down past all the courses until you get to her papers. It's no 4: "vitamin D supplementation results in secondary pantothenic acid deficiency producing sleep disruption, pain and neuropathy" (note she does use fairly high-dose vitamin D)

I'm glad you could follow my directions ! 😊

Marz
Marz
in reply to Scothyroidy

B12 and Folate/Folic Acid/B9 work together in the body in an important way ...

I too inject hydroxocobalamin several times a week with Folate. I have MTHFR and COMPT genetic defects. (from just one parent, luckily)

So I CAN'T process folate at all which is necessary to use needed B12.

Also an occasional B6 is added to help the B12 use. If didn't use all of those I would develop pernicious anemia.

My blood tests ALWAYS indicate very high levels of folic acid because my body CAN'T process it! I needed real folate, NOT synthetic folic acid. So don't think you're okay when your blood levels look high for folic ACID!

Hydroxocobalamin is just a natural form of B12. I can't use synthetic B12, regular cobalamine. I also have thyroid disease and use T3 and T4.

Hope this helps.

I ment sups!

Anyone with gut issues - rather than stomach - could have B12 issues. B12 is picked up in the Terminal Ileum and sent back to the liver for re-cycling. Due to surgery I do not have one and have suffered the consequences.

My B12 results were around 300 for years due to supplementing - so they were skewed. I now know better and self-inject weekly ...

smilingjane
smilingjane
in reply to Marz

Hi Marz

This is all new to me, looking at the B vits etc in relation to Hypothyroidism. Wondering why injecting is better than sups?

Marz
Marz
in reply to smilingjane

Injections not affected by absorption in the gut ...

smilingjane
smilingjane
in reply to Marz

Ah .... I see

So do you think that I should stop all B sups and ask my GP if I should be tested for B12 deficiency? (I have been on Thyroxin for 30 years, not much of the T. gland left now).

I had an small intestine resection years ago and have always had gut problems.

So different topic but why do doctors say to pregnant women to take folic acid and not folate?

I had to have b12 injections when pregnant as my levels went very low out of range. In fact pregnancy affected everything vitamin wise and thyroid wise. Hormones.

You might want to make that question your own post to get plenty of answers 🤗

helvella
helvellaAdministrator
in reply to Lovecake

I agree, Lovecake, that a separate question might be a good idea. But the reason appears to be that, for most people, folic acid is OK, at least at the lower end doses. And it is a lot less expensive. (£1.00 for 180 * 400 microgram tablets at Morrisons.)

groceries.morrisons.com/web...

I inject hydroxocobalamin several times a week with Folate. I have MTHFR and COMPT genetic defects. (from just one parent, luckily)

So I CAN'T process folate at all which is necessary to use needed B12.

Also an occasional B6 is added to help the B12 use. If didn't use all of those I would develop pernicious anemia.

My blood tests ALWAYS indicate very high levels of folic acid because my body CAN'T process it! I need real folate, NOT synthetic folic acid. So don't think you're okay when your blood levels look high for folic ACID!

Hydroxocobalamin is just a natural form of B12. I can't use synthetic B12, regular cobalamine.

Hope this helps.

I also have thyroid disease and use T3 and T4 for that.

I have MTHFR homogeneous genetic defect which means I got from both parents and it has double copy. This genetic defects increases homocysteine which means my body is not absorbing Folate as it can’t convert folic acid into Folate. For this if I take synthetic folic acid then it only increases my BP high, what I need is Folate. Though some doctors will tell you no folic acid and Folate is same and it’s just marketing I still say try yourself and see the difference.

MTHFR genetic can cause various health issues, endocrinological is not known but how t does effect immune system, causes many allergies from pollen to crossed allergies to many foods. It also makes BP high and different types of multiple polyps in your colon. What I read if you have this genetic defect and high BP then combination of Folate and vitamin B2 with lower dose will decrease the high BP especially diastolic one which I have a issue too. Moreover if one gets polyps in colon then combination of B6 and Folate is good. It can also prevent colon cancer which is common among MTHFR patients.

Please bear in mind MTHFR is a very common genetic mutation which many of us never got to know or realize. Anyway, in any case I would recommend to ask your doctor to do blood test of all vitamins before you take any of them.

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