AFAIK from here and elsewhere, according to NIH, no maximum dose has been identified. Many people here on NT have/are taking 1-5 mg/day (1000 - 5000 mcg) of methycobalamin/day. My wife & I have both taken 5 mg/day, and on occasion have gone over that, without any adverse reactions.

If you're concerned, depending on your test scores, you might try a bottle of 1000 mcg the first month, begin at 1000 (1 pill/nugget) per day (on an empty stomach, at least an hour before eating anything) and titrate up to 5000. Take it from there depending on reaction/goal.

Doc

In Melody's case, it may be from all the nails she chews... :p

If you tell it to get a laugh, it's funny. Humor is an odd thing; a person's misfortunes are never funny to them, but we've (human beings) been laughing at pratfalls since Adam fell off that ladder reaching for a banana....

Doc

Speaking of nails, I read somewhere online that your fingernails look different when your B12 is low. Do you know if this is true? Supposedly the "white" moons fade (less opacity).

Cats get intestinal inflammation, now thought to be due to wheat and corn and other grains in their food. New information coming out of the Vet schools, is to not feed grains to cats.

Hence we are using Blue Buffalo Wilderness brand now.
We had a cat--Sheba-- who was allergic to corn. But when I changed her to IAMs Eukanuba from Science diet (this had corn first listed in order of content)...her skin cleared right up!

Oreo since she has been ill and lost weight, has been on methyl B12 2 or 3 times a week. I mix it in her treat--whipped cream, and she accepts it (5mg).

There is a website on the net about a diabetic cat who uses 5mg a day orally too.He was numb in the hind quarters, and dramatic in presentation very unlike Oreo who physically is still strong (and runs around). Two of the vets we've seen so far with Oreo's cancer, recommended B12 for her. It is becoming very common in cats to be deficient!

I don't think the fingernail thing is reliable 100%. I have a B12 level of 1999 now, and I still only have moons on my thumbs!
I think it has to do with how your fingers are formed, and the cuticles etc.

@ Deb--- I would just swallow the B12 and not do it sublingually. See if that works. Take the whole 1000mcg and swallow and make sure it is on an empty stomach. Some people react to flavorings and colorings in the tablets when in long contact with the mucus membranes of the mouth.
A very small portion will be absorbed passively this way, and may work for you.

People very low in essential fatty acids, cannot maintain the integrity of the skin and mucus membranes. You must eat omega-3 oils, in the form of flax, etc, or eventually you will not survive. Your skin reactions, and everything may point to deterioration of your skin areas which we all repair and maintain with Omega-3s. Since you do not eat fish, you are not getting any from there either.

Also the vitamins in veggies are mostly betacarotene, not real Vit A... one cannot get too much Vitamin this way.
http://drbenkim.com/nutrient-vitamina.htm
This explains it well.
If your skin becomes a bit yellowish/orange like, that demonstrates a potential low thyroid condition. Thyroid hormone converts betacarotene into Vit A in the liver. People with hypothyroidism therefore get low in Vit A and deposit the pigment from the carotenoids in the skin of the palms and feet.

Good morning, mrsD and all...Omega-3 oils..allergic to flax seed, but I eat Bison often, a good source of b12 and omega-3. I have swallowed the tablet twice...allergic to the fillers, as I am to all fillers. Manitol in the tablets caused my kidneys to malfunction, depleted my potassium by day's end..more problems..lol. The liquid subligual has a preservative, of which I'm leary, but when I switched to asubligual liquid with only water added, no preservatives, the choking, swelling and wheezing was much worse. I went back to the original sublingual. I have also tried swallowing the liquid, resulting in more dramatic adverse reactions.

The immediate neck and tendon pain relief from the liquid sublingual is phenominal. My initial higher doses for 1 month seemed to have healed much of my myelin, but I don't seem to be able to store any extras with the low doses. The constant coughing and reaction to my hormones is my concerns. My nurse prac suggested needing progesterone now, but using it would most likely cause problems. I lives on tofu until post menopause. After that, even 1 serving caused my monthly flow to resume which required yet another invasive biopsy. Food, suppliments, meds, even at the lowest dose cause immediate reactions, never good ones.

I have turned myself orange in the past by eating sweet potatoes. I know better. Thyroid is working well. The vit a food thing, well, I'm not so sure I wouldn't be a first to OD on greens..lol.

I'm sure I passively absorb some b12 because I'm still alive, however, the pain control is essential. This has to be intestinal related, with inappropriate results. I have an injured gut and it doesn't know what it's doing. I know several people with motility diseases that have been told to never take b12. I wonder how they survive. I'm researching this also...worries me..

Thanks for the mind stretching questions, keep them coming as you all think of aything. I'm looking for docs to question and will make an appt with my nutritionist first thing on Tuesday...Happy Martin Luther King's day to all of you, by the way..Think I'll go take a drop of b12, cough a bunch and hope for the best.

Oh, my..just read about Orea. I have a year old dog with severe hip abnormalities, on rimadyl twice daily. It's not hip diysplasia. I was just thinking about asking my vet if it was appropriate to treat with some b12. I'll do that this week also, but if she starts swelling or coughing...I'll KNOW it's a black cloud hanging over my house...LOL...

deb...

I've read that B12 deficiency causes candida, but the B12 I am taking has fructose, and sugar or fructose can lead to/exacerbate candida.

Any truth to that? My core temp today has dipped to 95.6F, which is my worst ever. I'm trying to figure out why. I don't eat sugar and only have a little natural honey.

Energy level is way down with low core temps.

psoriasis and celiac are not that uncommon together....and with a child dx'd
your odds of being celiac go up. The blood tests have as much as 30 FALSE negative. Try a totally gluten free diet for 4-6 weeks and see if there is improvement. But it most be total!

pabb, thanks for your reply. I had the upper and lower gut testing for ceiliac. All good. I know about going completely gluten free due to my daughter and tried it for 1 month, just in case I was wheat sensitive. I am strick when it comes to food. Well, my weight dipped to below 90lbs and I became more obstructed to the point of more testing, which is always hard on me. The b12 cough didn't change a bit. It's not gluten. It's not dairy. Beef, Bison, any fortified foods, all make my cough worse. Until starting the b12 suppliment, none of these foods caused me any problems. Oh, and my gluten foods are 1 piece of whole grain toast, 1/2 cup of fiber flakes, with only wheat as the gluten source and Bobs Red Mill gluten-free oats, which my daughter can not tollerate. I can't tollerate rice.

I'm leaning towards my b12 intolerance having to do with another vitamin/mineral absorption problem. I obviously can't start another suppliment. I'm seeing my ENT and MY gastro next week. Maybe they have a suggestion. maybe know of another situation like mine, maybe have a miracle to offer.

I'm still low dosing and coughing. The lower the dose, the less side effects, but more pain and numbness I have. After 4 days of 50-60 mcg, and this is my "higher doses", my emotions are a mess...anger and hysteria....but boy, can I move well. b12 is messing with everything I took for granted. There's an answer..just can't find it yet.

Stress? hair products, as in perms all of my life? psoriasis or psoriatic arthritis? My gut directing the b12 in an inappropriate manner due to the obstructions, missing small bowel sections? Vagus nerve damage?

thanks for the input...
deb...

Vitamin B12 – Clarifying Some Misinformation

Nice article and a few interesting public comments below it.

Another reason not to watch "The Doctors show"...

Methylcobalamin does not last "minutes" in the body.

Beware of comments on internet sites.

I cringed at that comment (lasting minutes), mrsD...I'm so sensitive to methylcobalamin that a small amt causes drastic changes in minutes and hangs on for 24 hrs. Each small dose represents a slight change in my deficiency status, for lack of a better way to describe it, which remains. My inadequate dosing of suppliment shows just how important keeping a steady amt of b12 in our system but it also shows me how I have stored enough b12 to keep some of the more serious deficiency problems at bay.

Food with B12
 

Can I pig out on meat?

I read meat is a good source of B12.

Dietary sources of Vitamin B12 (mcg / 100g)

Lamb's liver 54
Pork liver 23
Lamb 2.1
Beef 1.8

I stopped eating meat last year when my BP got high. Now my BP is down from 127/93 to 108/66 (thank you, Magnesium Chloride).

I'm ready to eat high on the hog again, and I found a really good local butcher's shop...

Hi. I hope you are kidding when you ask that question.

People should never "pig out" on any animal products. I don't think having a steak once a week would do any great harm, I can't imagine eating meat and potatoes every night and it not doing any harm to one's body.

Think PLANT BASED DIET and take Methyl B-12.

I've been doing this for YEARS and boy has it paid off.

Melody

B12 deficiency symptoms?
 

Hi all,

For a year now I have been suffering from some random symptoms that up until this point have still not been diagnosed despite seeing various gps, specialists and ers over the last year. I had many tests including endoscopy and colonoscopy, ultrasounds, ct scans of the abdomen and MRI of the brain with not much being found besides some mild chronic gastritis which I have tried numerous diets and medications for and a pituitary prolactinoma which my endo said would not cause my symptoms and I guess she is right because their has even no change in symptoms in the 2 months I have been on medication for it. Also had blood tests for thyroid, cortisol and reproductive hormones - all normal. So I feel like there is something else causing my problems because I can tell my body doesn't feel right even though the doctors say they cant find anything wrong and basically say live with it or try antidepressant/anxiety meds which I did actually try because I thought I might be crazy and still no improvement besides being less moody about feeling sick 24/7 haha. Which brings me to my symptoms, I have been experiencing daily chronic nausea and loss of appetite, numbness and tingling in my hands and feet, ringing in the ears and I will randomly be short of breath and have a rapid heartbeat without doing anything? I also experience dizziness sometimes and my toe nails seem to crack alot and feel rough. My hair doesn't seem as healthy as it use to, very brittle and falling out and I even saw a few grey hairs and I'm only 18! my skin appears more pale than it use too also but that maybe due to me not going outside as much as before? Also one other thing I have noticed is that I got cuts/sores on the corners of my mouth a few times since I've been sick and I've read that can be a sign of b12 defiency? The only problem is I've had a full blood count and my haemoglobin and mcv are within normal range with haemoglobin at 148 (120 - 160) and mcv at 90.6 (78 - 98). What I have noticed though from some of the results I have is that there is an upward trend in my mcv with a result from 04/09/2008 reading 85 then a result from 19/03/2011 reading 86 and then another reading from an er on 28/03/2011 at 90.6. Seems strange to have a 4 point jump after only 1 point difference since 2008 and the first 2011 reading but I'm not sure if it means anything. Just also wanted to note that I have not had my b12 level or folate level tested and only my serum iron was tested so is it possible that I do have a b12 defiency still? Or perhaps some other kind of vitamin defiency? I have been tested for alot with no real results so I'm not sure what it could be!

Anyway thanks for reading :)

Ps. This whole thing started a week after I had just got over some kind of viral stomach bug, not sure of that may have triggered it somehow?

Welcome to NeuroTalk:

I'd get tested. Results in other countries may be given in different "units" than US testing.

It is true that an elevated MCV indicates possible low B12.
But you are not out of range yet. Some people, do feel better on higher blood levels of B12 than others.

Also if you take acid blocking drugs, then you will be not absorbing B12 from your animal food sources efficiently.

Frank anemia may not happen until you have been low for a LONG time. So anemia is not a good barometer for low B12 issues.

The testing is simple, and you can get MMA and Vit D done too.
MMA may show more information combined with the serum B12.

Cracking at the corners of the mouth can be herpes, or cheiliosis (Bvitamin deficiencies), or the yeast, Candida infection. Using alot of antibiotics can promote Candida. B12 deficiency also causes a bright red tongue.(the color of raw beef).

Hi mrsD,

Thanks for your reply :), I have just been to my GP and asked to get some vitamins checked, fortunately for me there was a student doctor there and as soon as I mentioned the tingling in my hands and feet she suggested the possibility of b12 deficiency. When I had mentioned this to my GP months earlier she just shook her head and said "i don't know, I don't think it's a problem". Maybe because I was very sick at the time she didn't take much notice because it was a minor complaint. Anyways I have now had blood drawn for b12/folate and vitamin D (because my mother was low) and she also added zinc and magnesium along with a FBE and LFT's. Unfortunately there was no MMA test added, but i will ask the GP at my next appointment if all comes back normal.

I actually did take Zantac for 2 months twice a day but this was after I become ill and I'm not sure if that's a long enough time to cause a substantial deficiency. I also tried Nexium and Pariet but both made me feel much worse after a few days.

My GP doesn't believe I could have a Candida infection and from what I've read the diet is the main way to get rid of it, which I have tried with many others but maybe not for long enough? And I have taken three different courses of antibiotics over the year for repeated UTI's but I made sure to take probiotics with each course and kept taking them long after I had finished each course.

Moderation in all things - including excess. :D

I'm on a high protein diet for intractable pain that recommends meats & cheese even for snacks, but small amounts are enough (especially because I'm trying to - and am - losing weight on this diet).

I don't think I'd want to pig out on meat even if I wanted to (redundancy intentional) - it just makes me feel... weird, especially red meats & coldcuts.

As I posted earlier in another thread here someplace, eating more slowly - taking at least 20 minutes to savor and enjoy smaller portions - also helps with the need to gormandize. You hit a brain-chemical satiation point sooner.

By all means, get and enjoy some really good cuts, but the pigging out part may not be necessary. It works for animals who, in the wild, may go several days between meals, but for humans with cultural backgrounds used to eating regularly, it may not be as healthy either.

Just my opinion...

Doc

@Jdeelm

Did you take fluoroquinolones? Cipro? or Macrodantin? Some drugs including antibiotics can cause neuropathies.

And do get the number for your B12 test including the concentration...pmol/L or picogram/ml. Don't accept "normal", as the ranges have not been fixed to reflect the new information as to what "normal" means.

I have a conversion table for those readers here in other countries.

http://www.unc.edu/~rowlett/units/sc...ical_data.html

The three antibiotics I have taken are metronidazole, trimethoprim and cephalexin. Not sure if those particular ones cause neuropathy but I have kept a diary of my symptoms, medications and appointments since I first got sick and from my records the tingling started before I was ever put on antibiotics and the first time I experienced it was about a month after initially becoming unwell. I have noticed however that the onset of my tinnitus is at the same time as my second course of antibiotics (trimethoprim) so I was wondering if it could be associated with that possibly?

Anyways I'll be sure to post my blood test results when I get them so I can get your interpretation of the results, but thanks for all your help so far I really appreciate it. :)

Metronidazole is a known PN causer.... sorry I have to tell you that.

http://www.neurologyindia.com/articl...3;aulast=Gupta

http://www.ncbi.nlm.nih.gov/pubmed/2154078

more on toxic neuropathies:
http://emedicine.medscape.com/article/1175276-overview

I'd still get the testing.
But for your case, since Metronidazole is a potential culprit...
I'd focus on the supplements that affect mitochondrial functions:

magnesium
R-lipoic acid (stabilized form)
acetyl carnitine
CoQ-10

My supplement thread:
http://neurotalk.psychcentral.com/thread121683.html

Thanks for all the links and supplement suggestions :). Just to clarify the tingling in my hands and feet started before I took any antibiotics so how could a medication I had not taken yet cause it? Although it might be contributing to it now it can't be the only problem.

Thanks again for being so helpful :)!

Tingling in the hands and feet are common in normal people.

When this occurs occasionally, it is called a paresthesia (not PN).
It can happen when cold extremities warm up (like when you come in from the snow, and warm up) or from low blood sugar episodes.

When it becomes a constant every day thing all day long, that points to a more serious cause and PN has to be considered. Drugs that are toxic to mitocondria, will damage them and add to the daily assaults that everyone gets from time to time and may push a temporary situation into a permanent one. Abberations in calcium metabolism also cause tingling. Fixing Vit D levels if low, may correct this cause.
Chronic hypothyroidism also causes pins and needle symptoms. This cause tends to last all day long because it is compressive in nature.

Thank you again for the information. My tingling doesn't last all day but does happen everyday serval times a day so i guess i have paresthesia. I also have had my thyroid testing except for free T3.

Today I got my results back from the gp and she said they are all fine.

B12 443pmol/L (162 - 811)
Red Cell Folate 1739 nmol/L (545 - 3370)
Vitamin D3 85nmol/L (50 - 300)
Ferritin 51ug/L (15 - 290)
Magnesium 0.9mmol/L (0.7 - 1.1)

When converting b12 I got 600pg/mL, so does that mean I don't have a deficiency as I read under 500 would suggest deficiency. Although another thing I noticed on one of the blood tests when I got home was a comment noting 'Mild Neutropenia' and when I did a quick search on the term b12 and folate deficiency came up as one of the causes which I found interesting but may not be relevant.

Mild Vit D deficiency may cause paresthesias, due to poor calcium control in the body. Improving your Vit D may help the tingling. Do 2000IU D3 daily for a month or two and see if there is any difference.

The low range in your test results is not really normal. You should really be at 150 or so (your units).

It would not hurt to try some methylcobalamin... 1000mcg daily orally on an empty stomach, and see if there is any change.

Another cause for numb feelings and tingling are episodes of low blood sugar. So if you log the times you get them, compare to what you ate before--up to 6 hrs before---to see if they come more often with high carb intakes (as opposed to high protein intake).

I think I will try the D3 supplement and methylcobalamin as these things could explain my symptoms and I've already tried alot of other things without success so hopefully this helps atleast a little bit. I'll see if any health food stores have the b12 otherwise I'll use the sites you suggested earlier :). So the 1000mcg would be enough instead of the 5000mcg?

I'll also keep note of when I eat in relation to the tingling as I do have poor eating habits since becoming ill.

With your B12 somewhat in acceptable levels, I don't think you need the 5mg dose. 1mg will raise you to about 1000 I think, and that level is good. Dr. Snow found some people in his study that he published, had relatively good levels of 400-500, and still had neuro symptoms. They improved with B12 supplementation, and he recommends trying it anyway if neuro symptoms are present.

We are lucky that B12 is safe to use, and we can do this ourselves. Other vitamins are have trade offs like B6 for example, and people have to be more careful with it.

Cobamamide question
 

Cobamamide which is also referred to as adenosylcobalamin and dibencozide is another active form of vitamin B12 that doesn't get nearly as much publicity as methylcobalamin.

I have heard that this form of B12 maintains different neurological processes within the human body compared to methylcobalamin. I believe that a portion of methylcobalamin is converted to adenosylcobalamin or perhaps visa versa.

My questions is do we need to take both forms to be safe? Is it possible that some people are adenosylcobalamin deficient even while supplementing with methylcobalamin?

I would be interested to hear any opinions on this. Thanks!

That is a complex question. I haven't seen much on this
as a medical problem, or on PubMed.

It is always possible because of some genetic flaw, the chemistry can get messed up, when enzymes don't work.

We have an article on Health news headlines, on twins today, and DNA flaws, that occur with aging. It maintains that DNA strands break and fail to perform in some people with aging.

http://neurotalk.psychcentral.com/thread164384.html

The following are some complex examples of the chemistry:

http://chemwiki.ucdavis.edu/Biologic...in/Cobalamin_1

The "R" group varies among the different cobalamins:
http://chemwiki.ucdavis.edu/Biologic...ymes/Cobalamin

This is an example of a specific use of cobamamide:
http://en.wikipedia.org/wiki/Cobamamide

For most intensive purposes, people who do not respond to
methyl B12, may have some genetic need for another type.
That I think is highly specialized, and difficult to find at the layman level.

from Dr. Sahelian MD:
http://www.raysahelian.com/methylcobalamin.html
Thus genetic failure can be serious...but I have no idea how that would be identified. I would think failure to respond, would suggest trying another form. But I don't think this is very common.

Thanks MrsD. I agreee that there isn't a lot of research regarding the use of adenoslycobalmin. It is a topic that doesn't get much attention. I think it should.

What really interests me is that this form of active B12 functions in the mitochondria by being at the base of the Kreb's cycle producing ATP. With all of the current interest in mitchondria damage and how it relates to PN, it seems like Ad12 could be a crtical cofactor in the reapir of nerve damage.

It appears that most people convert a portion of Mb12 to adenosylb12 within their body. I wonder if the conversion process is enough to recover from a potential deficiency of this active form of B12.

I have been taking this form of B12 along with Mb12 as an insurance policy to what I believe is improving my PN. Unfortunately, we just don't have enough solid information out there to know if this active form should be supplemented or not. Fortunately like MB12 there is very little risk of taking too much of this on a daily basis.

Yes, I agree with you... we are are supremely lucky that B12 is so easy to do ourselves. If we left this to doctors... well :rolleyes: we see commonly how helpful they are.

It won't hurt to take both. In fact before methyl became so easily available I used the adenosyl type myself from Country LIfe. I found that in a store near me a decade ago... in fact.

But I have never been really low in B12 either. My long ago first test was 849. I take it only as insurance, "just because".

I think it is more likely to be low in the methyl form because of methylation errors being found today... like MTHFR mutations, of which there are many. (I read once on a Merck site that a while back there were 25 of them...mutations so far. Maybe today there are more being found?

Let us know how you do with both.... this may be very helpful for some people on this forum.

For anyone who doesn't mind (or likes) getting in the weeds of biology, here's a great, concise little article on B12 and inflammation by Dr. Ayers:

http://coolinginflammation.blogspot....d-disease.html

In the first paragraph is a statement that supplements do not work for Pernicious Anemia. The author of this article has not yet discovered, passive absorption is possible with no intrinsic factor? This article is from 2008. There are studies from before that date showing oral B12 works.

There are studies that show oral supplements of B12 work for those with pernicious anemia:

http://www.ncbi.nlm.nih.gov/pubmed/20708373

http://www.ncbi.nlm.nih.gov/pubmed/17475180

http://www.ncbi.nlm.nih.gov/pubmed/17375844

http://www.ncbi.nlm.nih.gov/pubmed/16897048

I thought the end of the atricle regarding alcohol consumption was rather amusing. It could be inperpreted by some as drink more and you will live longer! :)

It seems like every month a new study comes out advocating drinking. :rolleyes:

On an unrelated note...

Does anyone here know if parasites commonly cause B12 deficiency?

I read one testimonial, but don't know if the patient's interpretation is correct. The claim is made it's a common problem.

An another site, the question is asked by a parent if parasites should be dealt with first before B12 supplementation.

I know supplementation works; I just wonder if people will get quicker results without parasites.

The tapeworms actually steal B12 from the GI tract.

Other parasites like Giardia, inflame the lining of the intestines
and reduce absorption that way... called malabsorption.

Anything that inflames the GI lining... gluten, food intolerances, toxins from bacteria, or parasites, can reduce B12 absorption.

Missed B12 Deficiency Diagnosis
 

"Patients with a history of intestinal surgery, strictures, or blind loops may have bacterial overgrowth that can compete for dietary vitamin B12 in the small bowel, as can infestation with tapeworms or other intestinal parasites....

"Use of methylmalonic acid and homocysteine levels in the diagnosis of vitamin B12 deficiency has led to some surprising findings..."

http://www.aafp.org/afp/2003/0301/p979.html

My aunt has a tapeworm when she was in her middle 20's. She lives in Germany and it was in the late 1950's when it happened. She got really skinny. Back then the doctor suspected the problem. She was put on a strict diet of salted herring. Apparently, these parasites can't tolerate the excess salt and it came out after about a week or so.

It was a scary event from what she told me. The tapeworm was very large. I think tapeworms are pretty rare, but it is possible.

With sushi now popular, the fish tapeworm is more common.
http://en.wikipedia.org/wiki/Diphyllobothrium

There is also a beef tapeworm, and that is less common in US.
http://en.wikipedia.org/wiki/Taenia_saginata

I bet it was truly unpleasant for your aunt. Parasitical diseases are
all rather creepy!

I was going to get tested in 1996, but I moved, and still haven't got around to it.

Dr. Jacob Teitelbaum, in his book From Fatigued to Fantastic, says:

"Most laboratories miss parasites when they do stool testing." (p. 133)

He tells how he'd send samples to local labs, which had a good rep, and they'd come back negative. So he stopped testing. But then he decided to do his own tests, and even though they'd take as long as five hours, they'd be positive.

The reason why so many labs fail? He says a technician told him their training lasts only one hour!

Bottom line: choose a lab that specializes in parasitology. Two he likes are: Parasitology Center and Genova Labs (formerly Great Smokies).

I just read that parasitic infections can cause chronic inflammation, so I think I'm going to get tested. (I went off gluten, milk, sugar, and foods that I was allergic to for six months, but still have what appears to be chronic inflammation.)

Testing for parasites is not a bad idea and is probably overlooked in most cases.

My current investigative path is on the subject of MTHFR gene polymorphism. It appears that a very significant portion of the human population (maybe 20-35%) have a genetic mutation that inhibits the production of converting synthetic folic acid into the active form of L 5 methyl-tetrahydrofolate. I have also read that these mutations can cause synthetic folic acid to compete with the active form thus causing a deficiency in that individual despite them supplementing with both types on a daily basis. That is the part that got my attention. My B-complex, country life Ad12, and multi-vitamins all had folic acid which I took everyday. I also took Metafolin which is the active form. Could there be a problem where the synthetic form neutralizes the active type through competition in the MTHR process? I have read of this ocuring in some patients where it was resolved by them taking the active form only. This phenomena appears to be getting more attention by the medical community. It might be more prevalent than we think.

My history of using acid blockers for many years combined with too much drinking likely effected my nutritional absorption of B12, folate, etc.

Folate deficiency can mimic the same symptons as B12 deficiency as stated in the article below:

http://emedicine.medscape.com/article/1171558-clinical


I removed all synthetic forms of folate ( except those found in some foods like bread) from my diet and now use the active form. This started about 3-4 months ago.

My memory the last couple months has made a noticeable improvement. My overall PN symptoms also have diminished somewhat. Time will tell if I'm on the right path.

The simple fact that MTHFR gene polymorphisms are so common should be something other people consider and look at. Also, consider using just the active form of folate in lieu of the synthetic type.