folic acid and b 12

I too have burning legs and feet plus numbneess. It is blamed on medication that stopped nutrients being absorbed by the gut. I also have an iron deficiency  anaemia. My B12 is 545 , it is below the range set in the US .however I understand that if one is experiencing neurological signs and symptoms as we are that the value is irrelevant and that Vit B12 injections have to be given according to some guidelines. Sorry about being vague I am new to this.

I understand that one has to take folate, folic acid and magnesium for B12 to work even when it is injected. Please correct me if I am wrong.

 

I assume the "mediication that stopped nutrients being absorbed by the gut" you refer to is a "Proton Pump Inhibitor" like lansoprazole which will affect absorption of B12.

As you say, although your B12 level is "normal" if you are having neurological symptoms then you should be treated in accordance with the N.I.C.E and B.N.F. guidelines.

Treatment of cobalamin deficiency

"Current clinical practice within the U.K is to treat cobalamin deficiency with hydroxocobalamin in the intramuscular form outlined in the British National Formulary, BNF, 

Standard initial therapy for patients without neurological involvement is 1000 µg intramuscularly (i.m.) three times a week for two weeks, then every three months. 

The BNF advises that for Pernicious anaemia and other macrocytic anaemias patients presenting with neurological symptoms should receive 1000 µg i.m. on alternative days until there is no further improvement, then 1 mg every 2 months.

However, the GWG recommends a pragmatic approach in patients with neurological symptoms by reviewing the need for continuation of alternative day therapy after three weeks of treatment"

Folate and folic acid basically are one and the same, Folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body. If your folate level is low you will need to supplement it or as my mother used to shout at me across the dinner table "Clive - eat your greens!"

hi clive.....just seeing ur message now.....her diet is o.k ish. But she is working on this now. When she went to doctor 2 years ago with the burning feet at night her folic acid was 5 which is low...dont know what her b12 was. he did nothing and she has had burning feet ever since now plus all the other syntoms. She is back at uni and struggling. I have now read so much on all of this. Few weeks back her folic was 3 and b12 400. But if u need folic to utilise b12 into the blood then on 3 her folic levels would not be high enough to push her b12 into the blood? My doctors are not great and just want to retest her bloods in 6 weeks from start of folic acid that would be in two weeks. She is feeeling better on the folic but hair still falling out..tired and depressed. I have today sent her sublingual b12 for her to start and we have nio time here and when she goes home I am going to see a porivate doctor...after all the horror stories i have read,,,,,many thanks clive

Your daughter taking some B12 supplements can do her no harm but a possible worry is that she may have an absorption problem with her digestive system which may be what caused her folate deficiency in the first place. Does she not eat vegetables?  Many breakfast cereals are now fortified with Folic acid so it's a bit of a mystery..

However as you say, her B12 levels were 400.so perhaps I'm "over worrying" about absorption.

I am not a medically trained person but I've had Pernicious Anaemia (a form of B12 deficiency) for 45 years and beside B12 injections every three weeks I've taken folic acid and iron tablets for more years than I can remember yet I'm still "clivealive" at 75.

hi clive....well over the past year she has been having digestive problems and is now gluten free so dont think that helped.....also she lives in a dark from in uni....and that is lack of vit d also not heloing her. Yes she does eat cereal..... very healthy looking lovely hair and skin...she eats a good diet i think a bit picky but not enough to make her unwell? We are a polish family and we cook from scratch etc. Yes her b12 was 400. But her folic 3? Apparently u need a folic acid of 14 to get good absorbtion of b12 into the blood cells ot the b12 sits in the gut and gives u a false blood reading...which is why u need more specific tests i.e mma? homocysteine. I am a nurse and administer the b12 injection but did not know all this just from research. I suspect that she has a true low b12 . When she comes back from uni i am going to take her to get sorted but for now i hope the sublingual b12 i have sent her helps. have read good reviews about this stuff.....I am glad you are still clivealive at 75!! Many thanks.....Ania

Hi again clivealive

​Thankyou somuch for this information I appreciate it very much.

​I have already order some vitamin B12 injections so as soon as hey arrive I can start the treatment as laid down in the BNFGuidelines.

I will need to get the folate as well.

DO you know if the injectable b12 will cause any bowel problems?

Thank you  xxx

 

Personally I have never had any bowel problems as a result of the over 600 B12 injections I've had.  However I would advise that you try and get the nurse at your doctor's surgery to give you the first one if you've not had any before just in case you do have an adverse reaction.  It is rare but best to be on the safe side.

It is recommended that you start taking the folic acid after your first B12 injection.

I'm a bit unsure why you are going down the self injection route.  Will your doctor not treat you?

Hi again

​No the GP is ignoring the neurological signs and symptoms that are worsening.

Have you thought to join The Pernicious Anaemia Society?  It costs just £20 for a year's membership and they may intervene with your doctor.

All these sad stories only serve to make me appreciate the treatment I have received from a succession of doctors and nurses at my surgery.

I wish you well.

yes you are lucky to have a good doctor? I live in the country and i have no choice of doctors. I think my daughter has become so ill because of a bad doctor. She went to him 2 years ago with burning feet etc .....symptoms of b12.....at this point her folic acid was just 5 and i now read on the pernicious anaemia society that it needs to be at least 14 to push the b12 into the blood cells. So esp last year she has been tired and many symtoms and i was unaware this was the cause i am horrified to be honest. She is trying to finish her uni course i feel she is close to breaking point.....and yet 2 years ago the doc just dismissed her problems. However i am going tp go private i dont want incompetant doctors looking after her after this esp as this is a complicated topic...

I will join. I am in agony with peripheral neuropathy and without suport from the GP. I have just taken delivery of a box of syringes, needles and skin sterilising swabs.........  sooo  ​all I need now are the b12 injections which were ordered the same day but from Germany!!!

It has cost me but when one is failed by the NHS then what is one supposed to do?

Hi again

Forgot to menion that I had a struggle to get blood reports from my surgery.

​I understand that my potassium levels need checking if on B12 but  how often? I do not think the surgery will agree to check them as they refuse to treat the Neuro signs and symptoms leaving me to suffer. It is all so unfair.

​Sorry to be so miserable. Thanks for your help .  xxx