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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 47527
Experience:  Board Certified Physician
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I have 3 monthly b12 injections and visited gp last week as

Customer Question

I have 3 monthly b12 injections and visited gp last week as I feel dreadful. B12 results 370 but folate was 2. I’m completely exhausted and sleeping around 15 hours a day this week-aching muscles, joints etc, excessive itching of hands and feet and what feels like heart racing/palpitations. I’ve actually phoned in sick this week as I’ve struggled for weeks but have struggled on but am now feeling quite poorly and wondered when I should improve? Now taking 5mg folic acid and next b12 injection due beginning of Dec.
Submitted: 20 days ago.
Category: Medical
Expert:  Dr. David replied 20 days ago.

This is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 20 days ago.

I am sorry you are not feeling well.

how old are you?

have you had your thyroid hormone levels checked? high thyroid hormone levels can raise up your metabolism and cause fast heart rate, poor sleep, dry skin

Customer: replied 20 days ago.
I’m 46 Thyroid was ok when tested last week. My skin isn’t dry at all-just itchy and worse in the evenings
Expert:  Dr. David replied 20 days ago.

I see.

as winter is coming, the air becomes more dry

you may need to use moisturizers on your skin to treat dry skin.

you may need blood testing to check your iron and ferritin levels.

you may have to improve your diet and exercise to help improve your energy levels.

you should have your vitamin D levels checked.

you should avoid alcohol and smoking as well

Customer: replied 20 days ago.
I haven’t got dry skin. Had all my bloods done-all ok except folate.
Customer: replied 20 days ago.
Expert:  Dr. David replied 20 days ago.

I see. what is your height and weight?

do you drink alcohol?

do you have bad anxiety symptoms?

Customer: replied 20 days ago.
No anxiety-don’t drink and height 5.4 weight 140lb
Expert:  Dr. David replied 20 days ago.

did your doctors check for autoimmune conditions?

ANA anti nuclear antibody testing

ESR erythrocyte sedimentation rate?

C reactive protein levels?

these are more advanced blood tests which are not usually checked with routine blood work.

Customer: replied 20 days ago.
Had fbc, liver, kidney function, ferritin, thyroid and b12/folate. I really just want to know if my symptoms are as a result of the folate deficiency and wondered how quick the folic acid will take to build up
Expert:  Dr. David replied 20 days ago.

folate deficiency is pretty rare now a days.

most people get enough folate in their system from foods and breads we eat

most foods in the US and UK are fortified with folate

your fatigue and your symptoms are caused by your folate deficiency

but the question is what is causing your folate deficiency.

Expert:  Dr. David replied 20 days ago.

folate deficiency can be caused by excessive alcohol intake and not enough normal food intake. but you don't drink alcohol

inflammation of your stomach or your bowels, allergy to gluten, inflammatory bowel disease can cause inflammation of your bowels which can keep your bowels from properly absorbing folate.

these should be checked for.

Expert:  Dr. David replied 20 days ago.

Some people have a genetic mutation that hinders their body from properly and efficiently converting dietary or supplemental folate to its usable form, methylfolate.

it can take several weeks to months to get your folate levels up

but if you have a genetic mutation, it may take longer.

there are more expensive blood tests to check for these genetic mutations.

there are blood test to check for celiac gluten allergy disease as well.

Let me know if you have other questions.
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Customer: replied 20 days ago.
GP said to take the folic acid daily indefinitely-I do eat plenty of the foods that naturally provide it. Tested negative for coeliac. In the short term what advice would you give?
Expert:  Dr. David replied 20 days ago.

do yo have diarrhea? mucus in your stool? you may need a colonoscopy to check for bowel inflammation.

do you have inflammation of your stomach or gastritis? this can cause poor folic acid absorption.

you may need stomach acid reducing medications to help decrease stomach acid.

avoid alcohol

drink plenty of water

you may have to see a GI specialist to see why you are not absorbing folate properly

Dr. David and 5 other Medical Specialists are ready to help you
Customer: replied 20 days ago.
Thank you
Expert:  Dr. David replied 20 days ago.

thanks for the positive feedback

would you consider 5 star feedback?

thanks for using JustAnswer.com

Customer: replied 20 days ago.
I selected 5
Expert:  Dr. David replied 20 days ago.

thanks.

I see 4 stars out of 5 come out

but thank you for your rating

thanks for using JustAnswer.com