# Folate deficiency



## Mark Parrott (Jan 20, 2017)

My wife suffers from a severe folate deficiency.  We eat huge amounts of folate rich foods, but she doesn't absorb the folate.  Doctor put her on folic acid tablets a few months back.  After the course, she had a blood test that showed a minor increase in folates.  Her most recent blood test showed it had gone back down again.  She is back on folic acid, but doesn't think it is doing anything.  She is suffering from all the symptoms caused by folate deficiency.  Her blood test showed her B12 is fine.  Just wondered if anyone knew what could be causing her body to not absorb folate?  A stab in the dark, i know.


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## Robin (Jan 20, 2017)

I had a cousin who had problems with folate absorption. (This was about 30 years ago, she was a lot older than me and died in her eighties a while ago, so a bit ancient history, I just say that to explain why I can't ask her!) She was eventually diagnosed as coeliac, which apparently was what was causing the folate malabsorption in her case.


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## Mark Parrott (Jan 20, 2017)

My wife has had testing for coeliac, and came back ok.  Thanks for your reply, though.


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## trophywench (Jan 21, 2017)

Doe anyone know why diabetic pregnant ladies need higher doses of folic acid than non-diabetic mums to be?  What is different about their body and is it possible to have whatever it is, outside diabetes and pregnancy?  Is it also poor absorption, if so, why?


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## mikeyB (Jan 21, 2017)

Mark, is your good lady on any medication that can interfere with folate absorption? Does she smoke?


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## Mark Parrott (Jan 21, 2017)

Yes, she does smoke.  She is slowly converting to vaping.  The meds she is on are Tramadol, Sertraline, Gabapentin & Adcal D3.


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## mikeyB (Jan 21, 2017)

Smoking increases the requirement for folic acid. I did a straight switch from pipe smoking to pipe vaping. Mixing the two doesn't work in giving up. None of the meds interfere with folate levels.  It's a question of eliminating possible causes, so get rid of the smoke and see where things go.


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## Mark Parrott (Jan 21, 2017)

Thanks, Mike.  She has just received a letter from the hospital with all the details on her last appointment.  It states also that she is vitamin D deficient & demands the GP puts her on a high dose supplement.  I think most of us in the UK are vit D deficient anyway due to lack of sun.


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## mikeyB (Jan 21, 2017)

Yeah, I'm on a high dose supplement, as are quite a few Mullachs, according to the doc. Over the counter Vit D supplements don't cut it.


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## Amigo (Jan 21, 2017)

Hi Mark, I recall you mentioning that your wife suffers with serious fatigue at times and I know there may be other reasons. However low folate levels would explain it too;

http://www.nhs.uk/conditions/Anaemia-vitamin-B12-and-folate-deficiency/Pages/Introduction.aspx

My mum has pernicious anaemia and it took some time to diagnose because apparently the tests are not always accurate. It may not apply to your missus but worth exploring. This link explains;

http://pernicious-anaemia-society.org/diagnosis/

My mum has just had blood transfusions in hospital as a result.

http://pernicious-anaemia-society.org/b12deficiencyandperniciousanaemia/

Worth pursuing if it's causing her problems and trying to get her B12 and Vitamin D levels up to optimal levels. I'm on mega doses of Vit D following blood tests and there's a great deal of research on the effects of low VitD levels and cancer hence my enthusiasm for keeping the levels high.


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## AndBreathe (Jan 21, 2017)

Mark Parrott said:


> Thanks, Mike.  She has just received a letter from the hospital with all the details on her last appointment.  It states also that she is vitamin D deficient & demands the GP puts her on a high dose supplement.  I think most of us in the UK are vit D deficient anyway due to lack of sun.



I had an Endo appointment last week, and the Consultant couldn't sop going on about my Vit D, which he reckons is the highest he's seen in a long time, never mind in January.  It was 80.

I didn't realise I was special in just one more way.


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## trophywench (Jan 21, 2017)

That 80 is sack in the middle of 'OK' actually AFAIK - the lab range of OK is between 50 and 150 - from memory when I had mine done (outside the normal NHS) and got the ref ranges with the result.

Mine was down in the low 30s some years ago when I had it tested (not by my GP - it's a long story and doesn't matter in this context) so Ittook it to my GP and he bunged me on capsules, one a day for the first X and then one a week.  So I went back after they ran out, of my own volition cos I wanted to know as he obviously didn't and DELIBERATLY when we'd just come back from 2 months in the Med instead of March as it had been the previous year.  He retested me, it was in the low 50s, so he decreed I didn't need any supplements thenceforth.  I've asked a few times, different GPs at my surgery, over the years since - and they've always refused to retest mine.

Much like a lot of folk with B12 deficiencies, I firmly believe the NHS generally deliberately undertreat both B12 and Vit D deficiencies (separately or together) in ordinary patients for the simple reason that it's almost always as a result of where the country is geographically rather than anything that THEY regard as an 'illness' that 'should' be 'cured'.

OTOH Scandinavian countries seem to take both very seriously ........


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## Mark Parrott (Jan 21, 2017)

Her B12 is apparently fine.  Just the vit D & folates that are low.  Her CRP & ESR are up & mild leucocytosis, whatever that is.


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## Amigo (Jan 21, 2017)

Mark Parrott said:


> Her B12 is apparently fine.  Just the vit D & folates that are low.  Her CRP & ESR are up & mild leucocytosis, whatever that is.



All those elevated levels are a sign of systemic inflammation and possible infection Mark.


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## Mark Parrott (Jan 21, 2017)

She has Fibro, osteoarthritis & inflammatory arthritis, so i think that's the reason for the high inflammatory markers.  Thanks for those links.  Very interesting.


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## Ditto (Jan 22, 2017)

Mark Parrott said:


> My wife has had testing for coeliac, and came back ok.  Thanks for your reply, though.


I read in Wheat Belly that it doesn't always show up? You can test okay, but not be okay, or something. Maybe try gluten free for a bit, see if that helps?

I believe everything I read, I'm so easily swayed.


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## AndBreathe (Jan 22, 2017)

My understanding is gluten intolerant doesn't always equate to coeliac disease.


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## mikeyB (Jan 22, 2017)

Ditto, please ignore everything you read in Wheat Belly, it is grade one bullshit from beginning to end, and is not supported by medical evidence. If you test okay, you are okay. End of. There are microscopic changes in the lining of the small bowel in coeliac disease. If they aren't there, you haven't got it. 

And where does gluten intolerance come from? Mankind seems to have gotten by for the last few millennia of cultivating crops. If your body is intolerant to gluten you get Coeliac Disease. If it isn't, you don't.

These are all theories by people who are nothing more than snake oil salesmen. Or in the case of William Davis, heart surgeons. If you watched the recent Horizon programme on Clean Eating, you would have seen this man being thoroughly dismantled by the presenter.

Don't get me wrong, you won't come to any harm following these diets, apart from maybe financial, but there's nothing that's so wrong with a normal healthy diet that these diets put right.


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## Ditto (Jan 22, 2017)

He says it's because we've messed about with the wheat and now we can't tolerate it. It's true I can't, my heart pounds and I get acid reflux. I do take everything I read to heart though. I'm too gungho.


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## mikeyB (Jan 23, 2017)

We messed around with wheat many centuries ago - even millennia. Wheat has been developed from wild grasses to allow mankind to become farmers rather than hunter gatherers. Recent changes to wheat are but tinkering compared to those early efforts at breeding a reliable edible cereal.  Same with all the cereal crops, including rice. Long grain, short grain, all are centuries old, not modern inventions.

So why is gluten and wheat intolerance on the rise? Well , with genuine gluten intolerance, Coeliac disease, modern medical knowledge allows these folk to live long enough to breed, where previously they would have starved. Now they happily spread the gene abnormality through the population. (The same, I might say, as all us diabetics).

Wheat intolerance?  If it's not associated with gluten: Largely a western complaint, not inheritable, no genetic basis. It's not an allergy. Nor is it an immune system condition. Can't be that bad, anyway, because detailed analysis of causes of death in this country won't show a single one caused by wheat intolerance. That doesn't stop snake oil selling nutritional experts ascribing every illness under the sun to wheat.

Discuss.


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## KookyCat (Jan 23, 2017)

In relation to the folate deficiency, I have issues with both B12 and folic acid and as it happens iron.  Have done since I was a kid.  It took them 30 years to work it out but I have a genetic issue with intrinsic factor.  The levels are absolutely fine, and no antibodies so not pernicious anaemia, rather it's to do with way B12 binds to the intrinsic factor.  The binding mechanism is wonky so it only picks up a percentage of what is available.  Mostly the body copes with that percentage because I eat a lot of B12 rich food, but as soon as I'm ill in any way it's off, which is why my B12 crisis also way correlated with illness (glandular fever, gastric flu, flu), B12 is also water souble so the challenge of diabetes and the drinking of all that water made the problem worse.  The interesting bit is, my B12 levels often came up OK, it was folic acid and iron that were flagged.  It's a long story but me and my dad were diagnosed at the same time because a dentist noticed symptoms in me that were more aligned with B12 deficiency, at that point I'd been taking folic acid supplements as prescribed for about 15 years (my dad was taking folic acid and iron as prescribed).  I can't remember the exact explanation for how this works but folic acid supplementation can mask a B12 deficiency (they mention a trap, I think they said methyl trap, but don't quote me on that!) so they did a different type of blood test and sure enough it showed my "available" B12 was very low.  Once the B12 issue was rectified (supplements and jabs) the folic acid followed suit.  Apparently there's a complex relationship between the two, I haven't shown up as deficient in folate or iron since the B12 situation was identified, prior to that I'd have 4 blood tests a year and show on at least one as severely anaemic or folate deficient.  Not all GPs are aware of the intricacies though, my current one was insistent I needed Folic acid prescribed because on one test it showed as marginal, this was because my B12 jab was overdue most likely, and my B12 was overdue because I was booked in for a test and I didn't want to skew the results.  This long amble about B12 may not seem relevant but my prior diagnosis was a non specific long term folate deficiency for which they could find no real reason.  The consultant who eventually diagnosed me and my Dad also mentioned that both of our B12 levels showed as marginal on all tests usually around the 200 mark, and that he and many others prefer a B12 level of at least 700, he would have wanted consistent readings at the 200 mark investigated, but both our GPs marked those results as acceptable because they are on the low end of "normal".   In fairness to the GPs we have/had a rare genetic disorder causing the B12 issue, but the consultant did say there was a large scale problem in diagnosing B12 issues so I'm guessing he saw a lot of it.  Just something to keep in mind if she's taking folic acid supplements.  I have all kinds of joyous nerve damage because it took them years to identify it, thankfully nothing life changing, but I could have done without it to be frank.  This might be entirely irrelevant for your wife of course, but I wanted to mention it in case there's a lurking B12 issue in the background.


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## Mark Parrott (Jan 23, 2017)

Thanks, Kooky.  That is very interesting.


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