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Dr. Hive - Folic Acid Deficiency?


scbusf
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I lost a long post earlier <sigh>
 

I have been so. tired. As in, I have to take a nap every day or I can't function. Saw my doctor and she ran a bunch of lab work. My folic acid was low and apparently that can cause fatigue. I had no idea. 
 

I do have hypothyroid, but that is under control. Vitamin D is borderline low, iron seems to be ok. I’m 49, in menopause, although I have a pituitary disorder and my hormones have always been low to nonexistent. But for some reason, my body is trying to go thru menopause. 
 

Just curious if anyone else has experienced this. 

Edited by scbusf
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Heads up that folic acid deficiency + hypothyroid = should be checked for Hashimoto’s to confirm it’s autoimmune stuff triggering the thyroid state + checked for MTHFR. 
 

MTHFR is both the name of the gene and the enzyme that converts folic acid and folate into methylfolate that the body can actually use. 
 

I did a quick Google for the info on how it’s all connected since someone didn’t return the book I had it in…this is accurate: https://advancedfunctionalmedicine.com.au/mthfr-and-hashimotos-disease/

Heads up that while my endocrinologist knew this, very few doctors outside of functional medicine do, so it’s important to be able to explain why you need testing…and specifically why you might need to take methylfolate and avoid commercially prepared grain products fortified with folic acid.

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Do you have a MTHF mutation?  (based upon the human genome project of the 90s, at least 50% of the population has at least one - you can have three.)  Heterozyous (1), homozygous (2), compound heterozygous (2), compound homozygous (3)

Folic acid is 100% synthetic.  It is NOT folate, and is not absorbed like real folate.

For those with a MTHF mutation - folic acid blocks the folate receptors and even with enough real folate in your diet, your body will absorb less if you consume folic acid.

 

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1 hour ago, scbusf said:

No to Hashimoto's and no to MTHF mutation.

Without being skeptical, do you know if you're heterozygous for the mutation? It also has an affect.

I forget the how/why but uptake of folate is closely correlated with B12 uptake as well. You do NOT want to supplement folic acid.  You want the natural form which is folate.  I actually went gluten free so I could stop taking in supplemented/enriched folic acid. (It wasn't the only reason.)

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B12 + folate have a lot of interrelationships. Folic acid deficiency can happen as a result of a b12 deficiency, deficiency in either can result in a low red blood cell count which can trigger anemia, and odds are if she has a folic acid deficiency something is therefore going wrong in the methionine cycle thus triggering fatigue and inflammation. 
 

Have they checked your inflammation levels, OP? ESR and c-rp? 

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1 hour ago, BlsdMama said:

Without being skeptical, do you know if you're heterozygous for the mutation? It also has an affect.

I forget the how/why but uptake of folate is closely correlated with B12 uptake as well. You do NOT want to supplement folic acid.  You want the natural form which is folate.  I actually went gluten free so I could stop taking in supplemented/enriched folic acid. (It wasn't the only reason.)

I will have to go back and check all my records. 

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1 hour ago, prairiewindmomma said:

B12 + folate have a lot of interrelationships. Folic acid deficiency can happen as a result of a b12 deficiency, deficiency in either can result in a low red blood cell count which can trigger anemia, and odds are if she has a folic acid deficiency something is therefore going wrong in the methionine cycle thus triggering fatigue and inflammation. 
 

Have they checked your inflammation levels, OP? ESR and c-rp? 

I am not sure about inflammation levels. I will check. 

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Here was the long part of the post I lost last night. I am 49 and have Hypopituitarism. My body is trying to go into menopause, even though my body has always made almost zero estrogen/progesterone. I have a bunch of minor, but seemingly random health issues - acid reflux, headaches, fast heartbeat, hypothyroid (not sure if that one is secondary to the pituitary function or not). Some of my doctors think all of this random stuff is related to the low pituitary function, but no one is sure how. The pituitary specialist I saw years ago wasn’t helpful. She told me to lose weight and that would solve all my problems. 

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DD’s brain tumor caused issues with the pituitary…specifically diabetes insipidus which required her to take vasopressin. Heartbeat and fatigue and hypothyroidism can all be easily tied to pituitary issues. I assume ACTH is also off and being supplemented? The rest are likely cascading.

49 isn’t necessarily early for menopause, all other issues aside. 

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The last time my ACTH was checked, it was normal - the lower end of normal. It’s been a while, though.

I know 49 isn’t early for menopause, my doctors and I were just surprised because I’ve never had a cycle and I’ve been taking hormone replacement for many years. We thought I might get to skip actual menopause!!

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Beans have natural folate.  Try to eat two servings of beans a day.  Bean dip, hummus, chili, split pea soup, baked beans, even beans blended up and used in lieu of flour in brownies (yep, two per day!).  If you add some green vegetables to that you should be above normal levels in less than 6 weeks.  And the good news it doesn't matter if you have a genetic methylation issue or not, the natural stuff in beans & greens works for everyone.

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