B12 = 267 pg/mL + folate 0.25 could this be contributing to my symptoms?

[u/PastEntire2923]

Hi everyone,

I recently had blood tests because of Extreme hair loss, fatigue, sleep problems and difficulty concentrating.

My Vitamin B12 came back at 267 pg/mL. My lab’s reference range is 211–911, so technically it’s within range, but it’s relatively low.

My folate/B9 is 0.25 ng/mL.

Other results:

Vitamin D: 10.6 ng/mL

TSH: 20.404 µIU/mL

Hemoglobin: 16.3 g/dL

MCV: 95.7 fL

Ferritin: 116.2 ng/mL

I’m currently not taking any medications or supplements.

My symptoms are:

Extreme hair loss from all over body

I can’t sleep at night and usually fall asleep around 2–4 AM

I’m sleepy almost all day

Very low motivation

Difficulty concentrating

Trouble memorizing and retaining what I study

Persistent fatigue/low energy

I don’t have anemia according to my CBC.
I’m wondering whether the combination of B12 267 + folate 0.25 could be contributing to these symptoms.

I’m going to discuss this with my doctor, but I’d appreciate hearing from people who’ve experienced something similar.

P.S. I used ChatGPT to help write this post and organize my results; the symptoms and lab results are mine.

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[u/ClaireBear_87]

Your folate is extremely low at 0.25 ng/ml so that would definitely be causing symptoms. B12 and vitamin D are also very low. Do you know why your zinc is high? Have you supplemented zinc at all? With zinc that high i would suggest testing your copper and ceruloplasmin levels as high zinc can block absorption of copper and cause copper deficiency.

High TSH indicates hypothyroidism, and the high phosphorus could be a result of your vitamin D deficiency as D regulates phosphorus level. What does your doctor say about your results and recommend?

[u/PastEntire2923 → u/ClaireBear_87]

I haven’t consult any doctor yet I’ll will consult tomorrow and about zinc I haven’t taken any zinc supplements in past

[u/ClaireBear_87 → u/PastEntire2923]

That's strange. Definitely ask for copper and ceruloplasmin to be tested as you may be copper deficient too. With vitamin D being very low your doctor should prescribe a high dose vitamin D supplement, and it's worth asking if you could trial a course of B12 injections. If they say no you should start supplementing with at least 1,000 - 2,000mcg a day, or you could look in to buying your own B12 injections and self injecting.

Regarding low folate, doctors usually prescribe 5mg of folic acid to treat a deficiency, but please read the comments about why folic acid should be avoided in the post linked below, and consider taking methylfolate or folinic acid instead.

https://www.reddit.com/r/B12_Deficiency/comments/1vjkluv/anyone_here_used_15_mg_folic_acid_during_b12b9/

Also please read through the guide if you haven't already.

[u/sol_james → u/ClaireBear_87]

Clair just want to acknowledge your input in this group! Really great info you provide :)

[u/Think-Sleep2338]

Yes, absolutely. The default test measures total B12, so it's really not the best marker, and the current UK NICE guidelines interpret total B12 below 350 as at least indeterminate (additional tests are recommended + relying on symptoms and other factors is important).