Your B12 and Folic Acid Labs May Be Misleading You
Looking at the levels of Vitamin B12 (cobalamin) and Folic Acid in your blood can help diagnose different types of anemias, investigate neuropathy, and evaluate general nutritional status. Low levels reflect the aspects of these conditions, while high levels may be significant for blood disorders (polycythemia vera or leukemia) or liver disease (cirrhosis or hepatitis). Often these conditions are ruled out and patients are merely left with the advice to discontinue all supplemental B12 and Folic Acid. However, as we learn more about methylation in the body, we have learned that a high B12 or Folic Acid blood value may actually mean a deficiency of these vitamins.
Vitamin B12 and Folic Acid require an activation process called methylation in order for your body to make use of them. Methylation is a process your body undertakes trillions of times every second – imagine billions of on/off switches inside your body that control everything from energy production and brain chemistry to your stress response and the repair of cells. We are seeing that a significant portion of the population (up to 40%) do not naturally produce sufficient enzymes required for this process. This can spell many problems for the body, such as a depleted immune system, fatigue, or increased anxiety and depression. You see, Vitamin B12 and Folic Acid are eaten through food and absorbed in gastrointestinal tract, but if your methylation process is not occurring well, they remain in the blood and your levels will be elevated.
The blood levels of B12 and Folic Acid can be misleading. If elevated, it does not automatically mean you should stop taking all B vitamins. It actually indicates that methylcobalamin (a form of B12) or methylfolate (the enzyme needed to convert folate to its active form) is necessary, and likely deficient. One key lab value that confirms this clue is homocysteine, an inflammatory blood value detected through blood levels. If either high or low, homocysteine actually reflects a problem in this methylation process. People who have elevated B12 or Folic Acid will also often have high homocysteine levels. Looking at these indicators can help evaluate a person’s genetic methylation status.
If this all seems confusing, don’t worry, you’re not alone! Think of it like this – the B12 and Folic Acid blood levels are like a river and a methylation problem is like a boulder or dam blocking that river. The unmethylated B12 and Folic Acid will pool in the blood. Simply not taking B vitamins would be trying to unblock the dam by taking out the entire river. Instead, giving appropriate methylation support will “remove the boulder” so to speak, by stabilizing the blood levels and normalizing the homocysteine levels.
As we learn more about the methylation process of B12 and Folic Acid, we find that the typical serum B12 and Folic Acid labs may reflect different information. In order to get a clearer picture, it is important to evaluate homocysteine through a complete blood count test as well. If you have been told to stop taking your B12 or Folic Acid due to elevated blood levels, ask your doctor to evaluate your methylation status. The news may surprise you.
Amy Nelson, ND* received her Naturopathic Doctorate from the National College of Natural Medicine in Portland, OR where she studied nutrition, homeopathy, herbal and functional medicine. In addition, Dr. Nelson was the Associate at The IBS Treatment Center in Santa Monica where she treated irritable bowel syndrome and complex food allergies. Dr. Nelson utilizes her experience in natural medicine to address female and male hormonal imbalances, mental health, and digestive disorders.
I have tested heterozygous for mthfr a1298c and just received blood work indication my folate level elevated at 24 and my vitamin b12 at 2000 and my homocysteine level at 11. Should I be concerned about my elevated levels? I have been taking supplements for my mthfr issue and now I am wondering if I should stop. Thank you
Good morning, I also practice alternative medicine as well as a active state caregiver for my 87 year-old disabled Mother. She is feeling the effects of cognition, weakness even when she trys to talk, Nerve pain in her foot or leg, fatigue. She is a Kaiser Hospital senior advantage member. In fact, she has an authorization of B12 shot (cyancobalamin) and she suppose to get her B12 every month. She had an appointment yesterday for the B12 shot, but we live an apartment and the elevator was not working.
I understood that Methylcolabalmin is better than cyancobalamin (for seniors) as she does not need to take folic acid (B9) which is a 2:1 ratio. I was also told that a minimum of 2.4 mg (or 2400 mcg) is necessary for seniors and adults on a regular basis (pregnant women need more)……
Is 3000 mcg of B12 ( Methylcolabalmin) better, and since it is water-soluble…could I put the drops of this in her OJ once a month or is better to take cyancobalamin at least tthree times a month?
Please advise…..Kaiser only injects 1000 mcg of B12 ( cyancobalamin) once a month…….she is not taking any other meds, prescription or otherwise,?
My Vitamin B12/Folate Serum panel recently tested at 1192 indicating it was high. Is this a major concern for me to address with my Primary Dr.? Thanks
Dr Nelson,
My husband has the MTHFR mutation on both. He also has high folate and high b12 blood levels. His homocysteines are 10.1. His ldl and triglycerides are high and his hdl is 40. Trying to figure out the best solution for his care and don’t believe VA is going to be of any help. Please tell me what you would do for a patient given these results. Thank you.
Thank you for your article! I have had very elevated B12 levels over the past year…last year the number was 2000 and this month it was 1700. I have heterozygus Methylation Gene Defect and am 63 and in basically very good health. I only take Nature-Throid for low thyroid as my only medicine. I have been using a Methylation B supplement but the B12 amount in it is not that high.
I rarely eat beef or peppers….I do have those peckulkee (little blood dots) in my skin in various places
on my arms, trunk and thighs and I also have chills quite alot and fatigue (poor quality sleep) as well as a constant runny nose.
Other than that, I’m great! LOL! Anyway, after seeing a myriad of websites about the causes of very high B12 levels, I got freaked out since each one said its either liver cancer or leukemia if these things happen. My CBC was fine 6 months ago.
What would you suggest? Should I see a Hematologist or just not worry about this high B12 level?
Thank you in advance for your attention. Linda, Bloomfield HIlls, Michigan