High RBC folate, low B12

[Milford]

I am asking for a friend. Her "diagnosis" is CFS. She is not taking any supplements at all. Lives in Canada, where food is fortified with Folic Acid.
RBC Folate 2283
B12 231

MTHFR C677T/A1298C +/+ Compound heterozygous
MTRR A664A +/+
MTRR A66G +/-
COMT +/- x 2

Definitely B12 deficient. But is the RBC Folate high because of the MTHFR or because there is not enough B12 there to utilize the folate? Or a bit of both !!

 

[Calathea]

My folate always comes back as off the charts when the doctors test it, but they don't actually show any interest in that. I've heard elsewhere that it might be due to low B12. Of course, they don't test the B12...

 

[Little Bluestem]

How old is your friend? As many as 4/5 of post- menopausal women cannot metabolize folic acid. It just accumulates in the red blood cells (and I think it interferes with the metabolism of other forms of folate). A person can have high RBC folate and be folate deficient.

 

[Milford]

How old is your friend? As many as 4/5 of post- menopausal women cannot metabolize folic acid. It just accumulates in the red blood cells (and I think it interferes with the metabolism of other forms of folate). A person can have high RBC folate and be folate deficient.

Thank you.... Do you have a reference to this or know why this would be ? She is 60.

 

[Calathea]

I was getting the extremely high folate readings in my early thirties, and I have no reason to suspect early menopause.

 

[Little Bluestem]

Thank you.... Do you have a reference to this or know why this would be ? She is 60.

Well I thought it did, but I can't find it now.

 

[mgd1972]

I just had a blood test with very high folate (more than 3000), but I have even supplementing with 20 mg or more of MTHF a day. One of the most prominent symptoms I have that made me this I was deficient in folate is peeling skin around my nose and fingernails, the peeling around the nose i didn't have before supplementing. So now I'm wondering, is that folate that I'm taking not absorbing properly, thus causing the symptoms and the high build up in my blood, or is the high amount in my blood simply due to taking too much and I should cut back? Any thoughts on this would be much appreciated!

 

[Valentijn]

I am asking for a friend. Her "diagnosis" is CFS. She is not taking any supplements at all. Lives in Canada, where food is fortified with Folic Acid.

Did the test specifically look for the active form of folate, or did it include folic acid? If it included folic acid, I would suspect it's an accumulation of an inactive form which she can't use.

With MTHFR C677T +/+, ability to transform folic acid into methylfolate is at 30% of normal. She might need to avoid folic acid (including from fortified foods), and supplementing an active form of folate might be helpful as well.

 

[Milford]

Did the test specifically look for the active form of folate, or did it include folic acid? If it included folic acid, I would suspect it's an accumulation of an inactive form which she can't use.

With MTHFR C677T +/+, ability to transform folic acid into methylfolate is at 30% of normal. She might need to avoid folic acid (including from fortified foods), and supplementing an active form of folate might be helpful as well.

Folic Acid is not included in a blood Folate test. Folic Acid is metabolized to Dihydrofolate in the liver by the enzyme Dihydrofolate reductase, and then the DHF enters the Folate cycle. Trouble is, people vary as to how well they can metabolize Folic Acid and there may be a lot of Unmetabolised Folic Acid in the blood.... This can be measured by a separate test.

 

[Vegas]

I just had a blood test with very high folate (more than 3000), but I have even supplementing with 20 mg or more of MTHF a day. One of the most prominent symptoms I have that made me this I was deficient in folate is peeling skin around my nose and fingernails, the peeling around the nose i didn't have before supplementing. So now I'm wondering, is that folate that I'm taking not absorbing properly, thus causing the symptoms and the high build up in my blood, or is the high amount in my blood simply due to taking too much and I should cut back? Any thoughts on this would be much appreciated!

Peeling of skin around the nose and fingers is a sign of riboflavin deficiency. Are you taking 20 mg or 20 grams of folate. If you are taking 20 g, then I would ask you why? Regardless, get some B2 in your system.

 

[alex3619]

Well I thought it did, but I can't find it now.

I read this study too but couldn't find it the last time I looked for it again. It was on nursing home populations I think, possibly in the US. Newer evidence is starting to show that just two slices of folic acid fortified bread is toxic, as the liver cannot process the folic acid into natural folate fast enough and it goes into the general circulation, and that is for normal healthy people.