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.