Hi
Can anyone tell me what the optimal levels are for B12 and Folate? I know mine are low because of my previous post but I don’t know what I should be aiming for.
(currently taking ERFA and thyroxine, thyroidectomy for Graves 25 years ago ish, now have hashis).
Thank you.
Spangle15
Active B12 - 84 (37.5-150)
Active B12 below 70 suggests possible B12 deficiency. We tend to suggest 100 plus for Active B12.
Folate - 20.5 (8.83-45)
Folate is recommended to be at least half way through range.
Who was this test done with?
Normally when the range starts with 8.83 the upper limit is 60.8 not 45.
Thank you for replying. It was done with Thriva.
Spangle15
OK, so Thriva have a very confusing way of showing their results and you appear to have taken the range from the coloured bar graph. If you go to your account and download the pdf form of results you will see the proper normal ranges there and you will see that the range for folate is 8.83-60.8.
Folate is recommended to be at least half way through range so that would be about 35 plus with that range.
With these results I would suggest that you supplement with a good quality, bioavailable B Complex containing methylcobalamin and methylfolate which should improve both of these levels.
I have used Thorne Basic B for a long time and always been happy.
If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this stops the body from using the B12. Vit C and B12 need to be taken 2 hours apart.
When taking a B Complex we should leave this off for 3-7 days before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).
Thank you so much SeasideSusie, I really appreciate you taking the time to reply. I will get myself some Thorne Basic B.
Hi Susie. Just to be clear re your last point, please confirm that we should stop Thorne B Complex supplements 3 days before testing due to 400mcg biotin content.
Medichecks don't mention this in testing notes nor in an email from them which confirmed no need to stop if taking to improve B12 level. It's mentioned below (Special Instructions) but only in context of biotin supplements medichecks.com/products/vit...
userotc
Biotin is known to affect many blood tests, not just thyroid, B12 and folate tests.
Medichecks have been inconsistent with the advice given about stopping supplements before testing.
A couple of years ago this is what they told one of our members who questioned their advice about biotin:
Because biotin is an ingredient used in many lab hormone test kits this can interfere with the measurement of thyroid hormones
It does this in an inconsistent way, causing falsely elevated results from some labs, and falsely low results from others. We recommend stopping biotin for one week prior to blood tests.
A little while later they altered their instructions to include information about leaving B12 off for one week but there was no information about leaving off biotin. I contacted them for clarification and they replied with the following:
I have discussed your query with our medical director he has advised the below:
Biotin supplements.
Biotin can affect the results of any test which relies on antibodies to perform the measurement. It is wise to assume that any hormone or vitamin test will be affected, which means that the majority of our test panels can be affected by biotin supplements.
The issue with Biotin only affects people who take high dose biotin supplements. The manufacturers of the laboratory tests define this as 5000 mcg per day or more.
We are recommending people do not take high dose biotin supplements for 24 hours prior to having their blood drawn.
If they are taking high dose biotin for medical reasons (e.g. multiple sclerosis) then a shorter washout period of 8 hours can be used.
Vitamin B12 supplements.
The answer to this depends upon what they are wanting to assess.
To work out whether B12 supplements are meeting the body's requirements we recommend not taking supplements for one week prior to having their blood drawn.
If a customer wants to assess whether they have an underlying B12 deficiency then it can take months (and potentially up to two years) for levels to fall to their natural levels after stopping supplementation. In this instance we would not recommend.
I can also confirm this information will be displayed on our test instructions in the near future.
I do my thyroid/vitamin panel with Blue Horizon and their instructions are:
Please Note: Because of the potential for interference with test results, samples should not be taken from patients taking BIOTIN in excess of 5 mg per day until at least 8 hours following the last biotin dose.
No mention of stopping B12.
So there's no consistency when it comes to advice.
If taking high dose biotin which generally would be a stand alone supplement then I think it's sensible to leave it off for 7 days. If it's a smaller amount, such as 400mcg in a B Complex, then 3 days should be sufficient. This is just my opinion, not actual fact because there is no actual agreement that I have been able to find, so it's up to the individual to make up their mind.
Susie
To add to your comprehensive database (!), Ive just received the following advice re 400mcg biotin-containing B Complex: "I would advise you stop the B complex supplement for at least 2 days prior to taking the test".
This confirms your advice is sound - which I never doubted!
That's interesting (and good to know 
). Just out of interest, where is this advice from please userotc it would be good if I could add the source when I quote it.
Sorry I shouldve said. Its from Medichecks' physician!
Ah Medichecks! They've changed their minds again 😂
Not sure if it helps but i recently got some labs. They included folic acid which was within the normal range (7.2, when the normal is greater than 5.4). However the labs also included a test called homocysteine. This came out as raised. Doctor advised that this means that my folate is low even though it is within normal limits, and i should supplement.
So maybe homocysteine is crucial to be tested along with the b12 and folate. It may show something the other labs don't.
Thank you so much, that is helpful.
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