• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

High folate and high B12 in blood tests

SOC

Senior Member
Messages
7,849
My daughter just got labs back that show high folate (>20, ref range 3.1-17.5) and B12 (1093, ref range 211-911). A simple Google search brings up a lot on deficiencies of both, but nothing on excesses. Does this mean it's no big deal?

She does not deliberately take extra folate or B12, although I'm sure her multivitamin contains folate and methyl B12.

Any ideas about what's going on here or if these lab results mean anything other than she's not deficient?
 

Mij

Messages
2,353
I'm wondering if your daughter should have her MMA and homocysteine levels tested to make sure there isn't a B12 deficiency. My understanding is that high levels of B12 in serum could mean it is not being utilized properly, so it's possible she might have a functional B12 deficiency.
 

helen1

Senior Member
Messages
1,033
Location
Canada
I agree, high serum levels can mean that your daughter is unable to transport B12 into the cells. She may be functionally deficient. MMA and MCV tests can help you see if this is the case.
 

SOC

Senior Member
Messages
7,849
I agree, high serum levels can mean that your daughter is unable to transport B12 into the cells. She may be functionally deficient. MMA and MCV tests can help you see if this is the case.
She has not yet had an MMA test, but her MCH has been high for 3 years and her MCV has been fluctuating between high and very high normal over the same time period. So maybe macrocytic anemia is a possibility?

Is functional B12 deficiency a well-accepted diagnosis or is this another thing my rabidly evidence-based medicine local clinic is going to turn their noses up at in scorn? :rolleyes:
 

helen1

Senior Member
Messages
1,033
Location
Canada
High MCV is an accepted marker in mainstream medicine for B12 deficiency, as is MMA, although MMA has been criticized as being too variable to be really accurate. However your GP may not know her mainstream medicine; mine didn't know the implications of high MCV.
 

SOC

Senior Member
Messages
7,849
High MCV is an accepted marker in mainstream medicine for B12 deficiency, as is MMA, although MMA has been criticized as being too variable to be really accurate. However your GP may not know her mainstream medicine; mine didn't know the implications of high MCV.
Sheesh. :rolleyes: I guess they get some kind of cognitive dissonance when they see high MCV and high B12, so they just pretend they didn't see either one to avoid the stress of having to figure out the apparently discordant info. :cautious:
 

Sparrow

Senior Member
Messages
691
Location
Canada
Yup. My MCV and MCH have been consistently high. But the standard response to that is to check B12 and folate levels. If B12 and folate aren't low, they ignore it.
 

Sparrow

Senior Member
Messages
691
Location
Canada
...Or at least, that has been my experience, and the experience of others who've mentioned it. I'm sure there must be better doctors out there, or ones who've had reason to become more familiar with that particular problem. It doesn't seem to be a common knowledge thing, though.