Folate's role in B12 Deficiency

[splithooves]

Just doing some reading:

When total folate intake was taken into consideration, the odds for peripheral neuropathy was 7-fold higher for the GG genotypes of TCN2 (OR: 6.9; 95% CI: 1.31, 36.36) if they consumed more than twice the Recommended Dietary Allowance of folate (800 μg DFE/d), but not if they consumed ≤800 μg/d.

https://www.sciencedirect.com/science/article/abs/pii/S0098299716300619

Based on this paradigm, we propose that the high serum MMA associated with the combination of low B12 status and high plasma folate status stems from the disruption of B12 hemostasis in the mitochondria, analogous to the effect of nitric oxide.

In conclusion, we have extended the findings of our recently published study of the interaction between vitamin B12 status and folate status in relation to anemia, macrocytosis, and cognitive impairment (11) by demonstrating that, among people with low serum vitamin B12 concentrations, high plasma folate is associated with higher concentrations of the two functional indicators of impaired B12 status, Hcy and MMA.

https://www.pnas.org/content/104/50/19995

I know all the protocols seem to involve some degree of excess folate supplementation, so I thought this was quite interesting.

In the case of B12 deficiency, is it possible that high folate levels could make things worse?

 

[Pyrrhus]

In the case of B12 deficiency, is it possible that high folate levels could make things worse?

I'm afraid I'm not sure what you're asking, but people often take B12 and folate (and sometimes B6) together as they are functionally interdependent. In the context of B12 deficiency, I believe there may be official recommendations to this effect, as one type of deficiency might mask another type of deficiency.

Some people like to take mega-doses of B12, but there's usually no reason for mega-doses of folate or B6. Although any excess of the water-soluble B vitamins is usually assumed to be excreted in the urine, there are a number of threads here on Phoenix Rising from people with very strange, very negative reactions to mega-doses of folate.

Hope this helps.

 

[Learner1]

there's usually no reason for mega-doses of folate or B6.

I'm not so sure about that. FIGLU is high in folate deficiency.

This is a case where need for folate is greater than B12. If you add a bunch of B12, methylation moved along more rapidly and more folate is needed. This also happens when one has genetics making less folate available.

There are pharmaceutical forms of folate, like Deplin, which is frequently doses as high as 15mg a day.

B6 is used in over 100 reactions in the body which compete with each other for the supply of B6. Oxaluria, or high oxalates due to antibiotics use killing off oxalobacter formigenes and other oxalate degrading bacteria in the microbiome can fairly rapidly delete B6, causing a number of other health problems as pathways are starved of B6.

I needed about 350mg of pyridoxal-5-phosphate daily for quite awhile without getting neuropathy.

@splithooves You are asking some good questions, but you need to look at how the pathways work. If you don't have enough B12, it'll be hard to use up folate...

 

[motorhead]

Did you get to 350mg of pyridoxal-5-phosphate by trials and errors? as it seems way off that chart. (I know it's not your chart, just wondering about the process)

 

[Learner1]

I kept testing over several months and it always looked deficient, even raising the dose. I also became aware that I had several processes all using it up. I learned, for example, that dealing with oxalates uses up B6 fast. A resource on oxalates said that some patients needed as much as 7xbodyweight in kg, so with that math, 350mg P5P is not excessive. The sources that warn against ingesting over 200mg of B6 are referring to taking pyridoxine HCl, which can quickly lead to neuropathy, where taking pyridoxal-5-phosphate doesn't seem to.

 

[motorhead]

Learner I always get the feel we would cover a small country GDP with your whole testing expenses)
I see, thanks. At x7 our weight we would mostly be at over 500mg then.

 

[Learner1]

Well, you can also waste a lot of money taking the wrong supplements.i do a comprehensive test once a year or so.

I took the 350mg daily for about 9 months while working on the oxalate problem then gradually ramped down to about 135mg a day.

 

[motorhead]

the test for that was a regular blood lab test or the Genova one?

 

[Learner1]

the test for that was a regular blood lab test or the Genova one?

You can do either. I prefer the Genova one or a Great Plains OAT test because they give me a lot of other helpful information.

 

[GreenMachineX]

I'm not so sure about that. FIGLU is high in folate deficiency.

View attachment 46322

This is a case where need for folate is greater than B12. If you add a bunch of B12, methylation moved along more rapidly and more folate is needed. This also happens when one has genetics making less folate available.

There are pharmaceutical forms of folate, like Deplin, which is frequently doses as high as 15mg a day.

View attachment 46323

B6 is used in over 100 reactions in the body which compete with each other for the supply of B6. Oxaluria, or high oxalates due to antibiotics use killing off oxalobacter formigenes and other oxalate degrading bacteria in the microbiome can fairly rapidly delete B6, causing a number of other health problems as pathways are starved of B6.

I needed about 350mg of pyridoxal-5-phosphate daily for quite awhile without getting neuropathy.

View attachment 46324

@splithooves You are asking some good questions, but you need to look at how the pathways work. If you don't have enough B12, it'll be hard to use up folate...

View attachment 46325

What blood test is that?

 

[Learner1]

What blood test is that?

Genova Diagnostics Metabolomix+ or NutrEval or Great Plains Organic Acids Test (OAT) would all work.