A diagnosis of vitamin B12 or folate deficiency anaemia can often be made by a GP based on your symptoms and the results of blood tests. Blood tests Tests for pernicious anaemia are not always conclusive, but can often give your GP a good idea of whether you have the condition. Referral to a specialist He K, Merchant A, Rimm EB, Rosner BA, Stampfer MJ, Willett WC, Ascherio A. Folate, vitamin B6, and B12 intakes in relation to risk of stroke among men. Stroke. 2004 Jan 1;35(1):169-74.

Mahmood L. The metabolic processes of folic acid and Vitamin B12 deficiency. J Health Res Rev 2014;1:5-9 Folic acid may interfere with the toxic and therapeutic effects of methotrexate. Methotrexate and trimethoprim are specific anti-folates and the folate deficiency caused by their prolonged use cannot be treated by Folic Acid Tablets BP. Zhang S, Hunter DJ, Hankinson SE, Giovannucci EL, Rosner BA, Colditz GA, Speizer FE, Willett WC. A prospective study of folate intake and the risk of breast cancer. JAMA. 1999 May 5;281(17):1632-7.The recommended dietary allowances (RDAs) for folate are 400 μg/day for adults and 600 μg/day for women of childbearing age. 15 Furthermore, many countries have initiated mandatory food fortification with FA to compensate for the losses and maintain adequate dietary intakes. It is recommended to take folic acid while you're trying for a baby (ideally for 3 months before) and during the first 12 weeks of pregnancy. Sometimes products tested by these three companies are more expensive to try to offset the cost they pay for certification.

Note this folate supplement is not a good fit for those who can’t metabolize folic acid, and it isn't high enough for pregnancy and lactation needs. Both vitamin B12 deficiency and folate deficiency are more common in older people, affecting around 1 in 10 people aged 75 or over and 1 in 20 people aged 65 to 74. Treating vitamin B12 or folate deficiency anaemia It is essential to carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included, relative to the recommended daily value of that ingredient. Please bring the supplement label to a healthcare provider to review the different ingredients contained in the supplement and any potential interactions between these ingredients and other supplements and medications you are taking.

Folic acid has a complex metabolism, and its effects depend on the concentration of the biologically active form, 5-Me-THF. Enzyme 5,10-methylenetetrahydrofolate reductase (MTHFR) is the key folate pathway enzyme involved in the formation of this biologically active form, and it is very polymorphic; approximately 90% of the European population has polymorphic forms of MTHFR. The two most common genetic polymorphisms shown to decrease the activity of MTHFR and influence the levels of biologically active folate are 677C>T (rs1801133) and 1298A>C (rs1801131) [ 11]. To investigate whether these two polymorphisms modify cell response to FA or 5-Me-THF, LCLs were genotyped for the polymorphisms rs1801133 and rs1801131 using TaqMan probes. Pfeiffer CM, Caudill SP, Gunter EW, Osterloh J, Sampson EJ. Biochemical indicators of B vitamin status in the US population after folic acid fortification: results from the National Health and Nutrition Examination Survey 1999–2000–. The American journal of clinical nutrition. 2005 Aug 1;82(2):442-50.

For children under 12, the doctor will use your child's age or weight to work out the right dose. Dose if you're taking methotrexate Zhang SM, Cook NR, Albert CM, Gaziano JM, Buring JE, Manson JE. Effect of combined folic acid, vitamin B6, and vitamin B12 on cancer risk in women: a randomized trial. JAMA. 2008 Nov 5;300(17):2012-21. Then, depending on whether your B12 deficiency is related to your diet, you'll either require B12 tablets between meals or regular injections. Most cases of vitamin B12 and folate deficiency can be easily treated with injections or tablets to replace the missing vitamins.

Devastating Impact Of High Homocysteine

Several large randomized trials of B vitamin supplements to lower homocysteine levels and prevent heart disease and stroke failed to find a benefit. [13-18] These trials had similar designs: adults who had a history of heart disease or stroke, or who were at high risk of heart disease, were given a pill containing high doses of vitamins B6, B12, and folic acid or a placebo. The studies found that taking high doses of the three B vitamins lowered homocysteine levels but did not lead to a reduction in coronary heart events. There are no known hazards to the use of folic acid in pregnancy, supplements of folic acid are often beneficial.

Many studies have reported that hyperhomocysteinemia was associated with numerous pregnancy complications, including recurrent pregnancy loss, 30 NTDs, 31 preeclampsia, 32 preterm delivery, 33 placental abruption, 34, 35 fetal growth restriction,36 and gestational diabetes mellitus. 37 Cawley et al also observed that neonatal birth weight and maternal Hcy levels were negatively correlated. 38 While the beneficial effects of folate supplementation in reduction of the risks of NTDs have been clearly demonstrated, 39-41 more robust meta-analyses are needed to assess its efficacy in preventing other congenital disabilities. 42-44 Institute of Medicine. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. Washington, DC: National Academy Press, 1999. If you have a higher chance of having a baby with a neural tube defect your doctor will recommended an increased dose of 5mg, taken once a day. Dose for treating folate deficiency anaemia Li Y, Huang T, Zheng Y, Muka T, Troup J, Hu FB. Folic acid supplementation and the risk of cardiovascular diseases: a meta‐analysis of randomized controlled trials. Journal of the American Heart Association. 2016 Aug 15;5(8):e003768. The level of folate and Hcy status is critical in the early stages of human reproduction. Investigation of the role of Hcy metabolism in patients with unexplained female sterility or secondary sterility due to recurrent pregnancy loss shows a positive association. Women and men with fertility problems may have low folate availability, which is often related to the MTHFR enzyme polymorphism. Preconceptional folate supplementation has been linked to beneficial reproductive outcomes in both natural pregnancies and those after ART treatment.

Forman JP, Rimm EB, Stampfer MJ, Curhan GC. Folate intake and the risk of incident hypertension among US women. JAMA. 2005 Jan 19;293(3):320-9. An increasing volume of publications related to folates and fertility problems have been published over the past few years, showing that 5-MTHF is a better option than folic acid to correct metabolic defects in gametes and embryos. In patients with repeated miscarriages and ART failures, Servy and Menezo observed a strong impact for the C677T MTHFR isoform. 51 Both partners could be responsible for the failure; it isn’t restricted to women. Abbreviations: 5MTHF, 5-methyltetrahydrofolate; DHF, dihydrofolate; SAH, S adenosylhomocysteine; THF, tetrahydrofolate. FullWell Prenatal Multivitamin was carefully crafted with the most recent research on the best forms of folate for fertility and pregnancy. The end result is this prenatal vitamin that has evidence-based forms and doses of folate along with other nutrients needed during pregnancy. Jain R, Manning S, Cutler AJ. Good, better, best: clinical scenarios for the use of L-methylfolate in patients with MDD. CNS Spectrums. 2020;25(6):750-764. doi:10.1017/S1092852919001469