Optimal serum folate level

[GussyG]

Hi All, can someone advise what this is please? I use Medichecks & Blue Horizon where the range is 8.83 - 60.8.

Many thanks

[SlowDragon Administrator]

at least over 40 and higher might be better

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70:

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

[helvella Administrator]

Until the past few years, folate ranges were often somewhat ridiculous - e.g. "greater than 3.5". With a questionably low bottom, and no upper end. More recently the labs do seem to have increased the bottom of the ranges and added. a top of range number.

If your result is well over 8.83, that should be just fine. There is no need to chase up towards the top of the range.

My own recent result was:

Serum Folate 8.83 - 60.8 22.2 nmol/L

Which in itself seems OK but I do consume quite a decent amount of folate-containing foods, and do intermittently take a B-complex, so was surprised it wasn't a bit higher. If I don't take a B-complex on a day, I often take a low dose folic acid.

[GussyG in reply to helvella]

Thank you both. Last year mine was 40 and now it seems to be getting lower - 28 last summer, now 21 in January. It’s still well within the range but had wondered why it was on the lower end despite taking a decent b complex the whole time. Meanwhile my serum and active b12 is over the range. I had read somewhere about the two being dependent on each other, is that correct?

[helvella Administrator in reply to GussyG]

Both are vital. And there are close connections. For example, if you have high folate that can mask some of the signs of low B12. Hence taking significant folate supplements can mask B12 deficiency but not fix all the issues - which get worse.

And there is ongoing discussion, pretty much argument, about the need for folate when on B12 injections.

My view is that while we might need some folate, the requirements will be very individual. And if you use folic acid, there can be an issue with unconverted folic acid building up. Methylfolate helps avoid that.

My B12 is high as well - but I take extra B12 every day so that is no surprise.

[NotElissa in reply to helvella]

I actually take folate gummies because the tablets were hard to swallow and they upset my stomach. At the moment I feel ok on them but I need to have a blood test to see if they are working

[helvella Administrator in reply to NotElissa]

I avoid gummies.

One random folic acid gummy I found very quickly says it contains:

Folic Acid, Pectin, Acidity Regulators (Citric Acid, Sodium Citrate), Glucose, Glucose Syrup, Glazing Agent (Vegetable Oil (Contains Carnauba Wax)), Sugar, Purple Carrot Juice Concentrate, Natural Peach Flavour

So that is three forms of sugar and an indeterminate "Natural Peach Flavour". Not good for us - our teeth and the rest of our bodies.

I already consume too much of too many foods. Adding that would simply be foolish for me.

[NotElissa in reply to helvella]

I knew there was a reason I liked them😋

superdrug.com/health/vitami...

[GussyG in reply to helvella]

Interesting. Can it work the other way around too so if you have high b12 that can lower folate? Just trying get a handle on why mine is going down.

I only take methyl forms of b vits.

If I was to cut back on my b12 that would mean stopping my b complex and then adding in the rest of the b’s separately, which would be a total pain and cost lots. I might try adding extra folate separately and see if that has an effect. Thoughts?

[helvella Administrator in reply to GussyG]

I can see little point in reducing B12 intake. Those B12-deficient people who insist on large intakes of folic acid (or other forms) point to the processing of the B12 in our bodies - how it works - to explain the need for it. Not simply the amount being swallowed or even injected. And no oral form will likely result in more than, say, about 10 micrograms being absorbed.

Potentially, I can see some sense in considering modest increase in folate intake (but probably avoiding folic acid above the basic 200 or 400 micrograms). I did notice you mentioned methyl forms but added the folic acid comment for anyone else reading.

[GussyG in reply to helvella]

Thanks Helvella. It’s a complicated area I feel, and one I’d like to get a better understanding of. Seems a bit remiss of me not to look at declining folate levels despite being on a b complex with 400ug of L-5-methyltetrahydrofolate in which I’ve been on for a good year or so. I’ve just made the switch to a different b complex with 667ug 5-MTHFR calcium in and 100ug methylcobalamin (other one was 500ug methylcobalamin) it will be interesting to see if there are any changes at my next blood test.

If there are no clinical implication of high b12 other than it’s high because you supplement and your body gets what it needs and you get rid of the excess, then seems fair enough to not worry about high b12. I get a lot of tinnitus and of course fatigue but can argue the same as hypothyroidism.

I’ve been thinking about testing for MTHFR and checking homocysteine levels but that’s another rabbit hole and money I don’t have. Will watch and wait for now.