B12 and Serum Follate deficiency

CraigC

Registered User
Mar 21, 2003
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London
Does anyone have any direct experience of B12 and Foliate deficiency in someone with dementia. I'm trying to get to the bottom of some worrying blood test from dad and to make sure it does not happen again. The home are a little unclear as to the cause and the SaLT specialist and nursing manager seemed to think it is not uncommon with dementia - something to do with absorption of B12 and Follate in people with dementia.

B12 normal levels should be 190 to 900 pg/mL (picograms per milliliter).
Dad's B12 level is 85 pg/mL

Serum Folate normal level is 3 to 20 pg/mL
Dad's Serum Folate leve is 1.3

He has been prescribed injections of B12 and syrup Folic Acid over the next month.

I've been uncomfortable with his diet for sometime and wish that we'd pushed for more fresh produce to be included in his diet. But they could well be right, just not something I've come across.

Dad is declining but has been particularly pale looking for last two months and a more pronounced gait to the right. There is a very mild improvement since the injections.

Any experiences appreciated.
thanks
Craig
 

jenniferpa

Registered User
Jun 27, 2006
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Craig is he taking any medications? Antacids?

According to medscape, Food malabsorption causes 60% to 70% of B12 deficiency. So it's not necessarily what he is or is not eating but possibly down to the inability of his body to absorb the vitamins he is getting.
 

sussexsue

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Jun 10, 2009
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West Sussex
Mum has to have B12 injections every 3 months, and has needed them for the past few years. This could well have been caused by a diet deficiency before she had a diagnosis and was living alone. As I understand it, once the body fails to absorb B12 naturally, diet alone will have little affect and injections will be needed for life.

Now to the awkward bit. I missed mum's last injection - just overlooked it, so she had effectively gone over 6 months without one. Didnt feel too bad at the time as I had never noticed that much difference in her. She had a UTI 4 weeks ago and never really recovered. Last week I was really worried as she was sleeping 22 hours a day and not eating - down to around 500 calories a day. Plus a huge decline in cognitive ability. Saw doctor who prescribed food supplement and ran bloods. I havent got the results as I was away when he phoned, but will speak to him later this week.

However, on Thursday she had her vit B12 injection, and the next day she woke up a completely different person. She stopped sleeping all the time, ate reasonably well and was mentally far more alert. It was as though someone had flipped a switch. This huge recovery is continuing.

I am presuming it is the injection as the change is so extreme. She doesnt take folic acid so cannot comment on that.

Her diet has become pretty poor over the last 2 years and she now refuses most vegetables and will not eat fruit. I guess my conclusion is that her continuing health will have to rely more on drugs than food.
 

nellbelles

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Nov 6, 2008
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leicester
Craig

Tom has been having B12 injections for about 3 years, me also for about 2. Both picked up by routine blood tests at the GP's. (my friend also aged 71 for 5 years)

So that is 1 with AD 2 without. My understanding is that sometimes as we get older the body cannot absorb B12.

I am a vegetarian and both Tom and myself eat masses of fresh veggies ect. I think it is just the luck of the draw.

No idea about the foliate though.

Helen
 

CraigC

Registered User
Mar 21, 2003
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London
Thank you all so much for your reassuring and helpful replies!
Dad is also just started food supplements to help build up his weight again. He is eating well (a lot more slowly thought) so there does seem to be an issue with absorption.

thanks again and I'll also speak to the GP about the long term plan with injections Sue, I'll question the approach of the injections being a temporary measure.

Thanks again
Craig
 

nellbelles

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Nov 6, 2008
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leicester
Craig

I have just remembered:rolleyes::rolleyes: ! !

Initially there is a starting dose of 3 injections each week for two weeks, then it is one injection every 3 months.

Helen
 

TedHutchinson

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May 20, 2009
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Louth Lincs
Here is a good site for B12 information
for most people the ideal way to take B12 is daily a sublingual spray or lozenge or drops. that way some will be absorbed through the tissues in the oral cavity.

Using injections means you go from high to low status over the period between injections. .
If you can stay steady but high it makes sense.
The active form (which avoids any problems with lack of enzyme to convert) is Vitamin B12 - Methylcobalamin there have been cases where doctors have given B12 cyanocobalamin injections without realizing the patient couldn't convert it.

B12 deficiency is mainly found in Vegetarians, meat eaters are usually OK.

5-methyltetrahydrofolate (5-MTHF) is the naturally occurring, biologically active form of folate. It's much better absorbed than folic acid.
 
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nicoise

Registered User
Jun 29, 2010
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Thanks Ted for all this - I always find your posts very interesting and informative.

My mum had B12 injections, and said herself that she could feel the difference when she had them in terms of being more mentally and physically alert and energetic.

I think I could do with that too!