Vitamin B12 / Folate Deficiency
What Does It Mean?
Vitamin B12 and folate (B9) are essential nutrients for DNA synthesis, red blood cell production, and neurological function. A deficiency in either can lead to anemia, neurological impairments, and elevated homocysteine levels, which increase cardiovascular risk.
How Did We Get There?
Root Causes:
- Poor Dietary Intake – Low consumption of animal products (B12) or leafy greens and legumes (folate).
- Malabsorption Disorders – Conditions like pernicious anemia, celiac disease, and Crohn’s disease impair absorption.
- Methylation Dysfunction – Genetic mutations (MTHFR polymorphisms) can impact folate metabolism.
- Chronic Alcohol Use – Depletes folate stores and impairs B12 absorption.
- Medications – Proton pump inhibitors, metformin, and certain anticonvulsants interfere with absorption.
Signs & Symptoms:
- Fatigue and weakness
- Numbness and tingling (neuropathy)
- Memory impairment and mood disturbances
- Glossitis (inflamed tongue)
- Pale skin and shortness of breath
- Elevated homocysteine levels, increasing cardiovascular risk
Lab Test Findings
| Lab Test Name | Expected Change | Optimal Range |
| Folate, Serum (Folic Acid) | Decreased | 15.00-27.00 ng/mL |
| Reticulocyte Number | Decreased | 0.04-0.13 million/µL |
| MCH | Increased | 28.00-31.90 pg |
| MCHC | Normal | 32.00-35.00 g/dL |
| MCV | Increased | 82.00-89.90 fL |
| Methylmalonic Acid (MMA) | Increased | 0.00-260.00 nmol/L |
| Neutrophil % | Decreased | 48.00-60.00 % |
| RBC (Male) | Decreased | 4.20-4.90 million/µL |
| Uric Acid | Increased | 3.50-5.40mg/dL |
| Vitamin B12 | Decreased | 545.00-11000 pg/mL |
| WBC | Decreased | 5.5-7.5 thousand/µL |
| Hemoglobin | Decreased | 13.50-14.50 g/dL |
| Homocysteine | Increased | 5.00-7.20 umol/L |
| Lactate Dehydrogenase (LDH) | Increased | 140.00-200.00 IU/L |
How Do We Treat It?
Functional Medicine Approach:
Correcting vitamin B12 and folate deficiency involves improving dietary intake, enhancing absorption, and targeted supplementation.
Supplement Protocol
| Supplement | Function | Dosage & Frequency |
| Vita B Methyl | Provides bioavailable methylated B12 and folate to support energy and cognitive function | 1 capsule without food, daily |
Additional Lifestyle Interventions:
- Increase Dietary Intake: Consume B12-rich foods (eggs, meat, fish) and folate-rich foods (leafy greens, legumes).
- Optimize Gut Health: Address malabsorption with probiotics and digestive enzymes.
- Reduce Alcohol Consumption: Minimize alcohol intake to support nutrient absorption.
- Monitor and Manage Methylation: Consider genetic testing (MTHFR) for personalized methylation support.