folate level greater than 20folate level greater than 20

This is when the brain or spinal cord doesnt develop normally. Can high B-12 levels cause symptoms similar to a deficiency? B12 and folate once more fell into the normal range. A few studies have examined whether folate status affects the risk of depression during pregnancy or after childbirth. These values, which vary by age and sex, include: Table 1 lists the current RDAs for folate as mcg of dietary folate equivalents (DFEs). Current time: 03/01/2023 04:04:39 p.m. UTC In adults, mean erythrocyte folate concentrations range from 216 to 398 ng/mL, also indicating adequate folate status [31]. Biofactors 2011;37:253-60. Dementia, cognitive function, and Alzheimers disease Your doctor may say Some dietary supplements also contain folate in the monoglutamyl form, 5-MTHF (also known as L-5-MTHF, 5-methyl-folate, L-methylfolate, and methylfolate). Folic acid (and vitamin B12) supplements lower homocysteine levels. 0000010745 00000 n An analysis of 10,789 participants from this trial found that folic acid supplementation significantly reduced the risk of stroke by 73% among those who had a low platelet count and an elevated homocysteine level (increasing their risk of stroke) but had no significant effect on participants with a high platelet count and low homocysteine level [95]. In: Erdman JW, Macdonald IA, Zeisel SH, eds. [, Roberts E, Carter B, Young AH. In most cases, serum folate testing alone is sufficient for assessment of folate status, but if there is strong clinical suspicion of folate deficiency and the serum folate level is normal and cobalamin deficiency has been ruled out, the red blood cell (RBC) folate level may be measured. J Nutr. However, secondary factors linked to depression, such as unhealthy eating patterns and alcohol use disorder, might also contribute to the observed association between low folate status and depression [119. 0000114923 00000 n Sometimes these red blood cells dont live as long as normal red blood cells. Med Hypotheses. Am J Clin Nutr 2011;94:303S-12S. Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial. Total folate and folic acid intake from foods and dietary supplements in the United States: 2003-2006. Evidence also indicates that folate might play a dual role in cancer initiation and progression [57]. [QxMD MEDLINE Link]. 2009 Nov 18. People with alcohol use disorder frequently have poor-quality diets that contain insufficient amounts of folate. Since 1998, when mandatory folic acid fortification began in the United States, NTD rates have declined by 28% [134]. [, Cleare A, Pariante CM, Young AH, et al. Intestinal blind loop syndrome can cause elevated serum folate levels. Serum folate measurement is preferred over RBC folate measurement due to considerable analytic variability (coefficient of variation) of assays. 140 (6):1246-1259. A 2015 expert panel convened by the National Toxicology Program and the National Institutes of Health Office of Dietary Supplements concluded that folic acid supplements do not reduce cancer risk in people with adequate baseline folate status. A free weekly iron-folic acid supplementation and regular deworming program is associated with improved hemoglobin and iron status indicators in Vietnamese women. [, Tu H, Dinney CP, Ye Y, et al. Honein MA, Paulozzi LJ, Mathews TJ, Erickson JD, Wong LY. [, Durga J, van Boxtel MP, Schouten EG, et al. Similarly, a meta-analysis of 13 randomized trials showed no statistically significant effects of folic acid supplementation (median daily dose of 2,000 mcg) over an average treatment period of 5.2 years on overall cancer incidence or the incidence of colorectal, lung, breast, prostate, or other cancers [72]. 0000249226 00000 n J Psychopharmacol 2018;32:377-84. [, Morris MS, Jacques PF, Rosenberg IH,et al. According to a 2006 article by Florence Aslinia, M.D., and colleagues, published in the journal "Clinical Medicine & Research," if you are a person with a vitamin B12 deficiency caused by pernicious anemia, your serum folate levels will tend to be increased, presumably because the methionine synthase pathway -- methionine synthase is an enzyme in humans responsible for the production of methionine, an amino acid -- is impaired, allowing methyltetrahydrofolate, or the most common form of folate, to accumulate in your blood. J Psychopharmacol 2015;29:459-525. Psychother Psychosom 2003;72:80-7. startxref Red blood cell folate concentrations increase more after supplementation with [6S]-5-methyltetrahydrofolate than with folic acid in women of childbearing age. In vitamin B12 deficiency, higher serum folate is associated with increased total homocysteine and methylmalonic acid concentrations. Intake recommendations for folate and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by an expert committee of the Food and Nutrition Board (FNB) at the National Academies of Sciences, Engineering, and Medicine [2]. 0000249080 00000 n For example, in a trial in France, 2,501 people with a history of cardiovascular disease received daily supplements of 560 mcg folic acid, 3 mg vitamin B6, and 20 mcg vitamin B12 for 5 years [58]. Important Note: Women who plan to become pregnant can benefit from higher doses of folic acid to prevent brain and spine defects in the developing fetus. In fact, many of the studies warned medical professionals to watch for deficiencies of folate and B12 in hemachromatosis. 67 Suppl 1:S69-72. U. S. Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. [QxMD MEDLINE Link]. Ann Neurol 2011;69:352-9. 10th ed. He suffers with chronic migraines, left side neuropathy and most recently severe depression. Circulation 2016;134:647-55. Likewise, the authors of the third update of a Cochrane review of the effects of homocysteine-lowering interventions on cardiovascular events concluded that folic acid supplementation alone or in combination with vitamin B6 and vitamin B12 does not affect the risk of myocardial infarction or death from any cause, but it does reduce the risk of stroke [97]. An evaluation in Portugal, where the food supply is not fortified with folic acid, found low folate status in more than 60% of people with chronic alcoholism [34]. 11th ed. 2012 Mar. In contrast, the transformation of homocysteine to methionine is a vitamin B-12dependent reaction. Even moderate alcohol consumption of 240 ml (8 fluid ounces) red wine per day or 80 ml (2.7 fluid ounces) vodka per day for 2 weeks can significantly decrease serum folate concentrations in healthy men, although not to levels below the cutoff for folate adequacy of 3 ng/ml [35]. Centers for Disease Control and Prevention. Biomarkers of nutrition for development-folate review. [, Schmidt RJ, Tancredi DJ, Ozonoff S, et al. For more information about building a healthy dietary pattern, refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture's MyPlate. Genest JJ Jr, McNamara JR, Salem DN, Wilson PW, Schaefer EJ, Malinow MR. [QxMD MEDLINE Link]. 12 (8):e0182099. [, Andreeva VA, Touvier M, Kesse-Guyot E, et al. [, Yetley EA, Pfeiffer CM, Phinney KW, et al. WebOne of the first symptoms of folate deficiency is extreme tiredness ( fatigue ). In any case, having an elevated folate level is not dangerous, a sign of any disease, or a cause of any health problems. J Am Coll Cardiol. Dizziness. Red blood cell folate and plasma folate are not associated with risk of incident colorectal cancer in the Women's Health Initiative observational study. 0000011208 00000 n Huanhua Road, Liwan District, Guangzhou,Guangdong (P.R.China). 0000033685 00000 n Folic acid for the prevention of colorectal adenomas: a randomized clinical trial. Am J Clin Nutr. [QxMD MEDLINE Link]. 244 110 Compared with placebo, treatment with B vitamins significantly decreased homocysteine levels but did not reduce the risk of death from cardiovascular causes or myocardial infarction. Lancet 2013;381:1029-36. When large amounts of B1 are administered the B12 levels come back down to normal. If you log out, you will be required to enter your username and password the next time you visit. 40(2):129-38. Neuroprotective effects of prenatal folic acid supplementation: why timing matters. Vitamin B12 and folate blood test can easily determine the level of folate and Vitamin B12 levels which are the 2 major B complex vitamins that the human body requires for many key functions such as making standard red blood cells, white blood cells, heal cells, and tissues besides synthesizing DNA. MMWR Morb Mortal Wkly Rep 2010;59:980-4. Pradyumna D Phatak, MBBS, MD is a member of the following medical societies: American Society of HematologyDisclosure: Received honoraria from Novartis for speaking and teaching. QJM 2008;101:881-7. The panel also determined that the consistent findings from human studies that supplemental folic acid has an adverse effect on cancer growth justify additional research on the effects of folic acid supplementation on cancer risk [84]. 6th ed. <<875E3892DB0649459F2F5E5D7B59E974>]>> High concentrations of folate and unmetabolized folic acid in a cohort of pregnant Canadian women and umbilical cord blood. Bailey LB, Caudill MA. [, Carmel R. Does high folic acid intake affect unrecognized cobalamin deficiency, and how will we know it if we see it? Few medicines such as sulfasalazine, methotrexate, trimethoprim-sulfamethoxazole, and phenytoin (Dilantin) may also cause this condition. Decreased intake of leafy vegetables causes fall of folic acid level in RBC Poor dietary intake Increase intake of Alcohol Intake of overcooked food Medical conditions which require more intake of folate as BMC Public Health 2007;7:41. The cutoff is based on consensus and was derived from the US NHANES III data.(4). Am J Psychiatry 2016;173:575-87. Because 7 of our 25 volunteers had folate levels greater than the upper limit of the linear range (20 ng/mL) of the E170 folate assay, we excluded these values from our data analysis. 31(2):587-623, xi. [QxMD MEDLINE Link]. Once a vein is found, they will insert the needle and draw some blood. Effects of homocysteine lowering with B vitamins on cognitive aging: meta-analysis of 11 trials with cognitive data on 22,000 individuals. In addition, women with the 677C>T MTHFR polymorphismwhich is more common in Hispanics than Caucasians, Asians, and African Americansmight have an increased risk of NTDs [1,3,27,40]. 0000250598 00000 n It inhibits the intestinal absorption of folate and can cause folate deficiency [170]. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjAwMTg0LXdvcmt1cA==. Folic Acid. Cardiovascular disease and stroke Food folates are in the tetrahydrofolate (THF) form and usually have additional glutamate residues, making them polyglutamates [1]. Your healthcare provider will figure out the best treatment based on: You may need to take folic acid supplements for at least 2 to 3 months. JAMA. In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients (e.g., during specific life stages such as pregnancy).". In the United States, women consume folic acid from three sources: enriched cereal grain products (i.e., fortified foods), ready-to-eat cereals, and supplements. [QxMD MEDLINE Link]. The results showed no significant associations, however, between supplementation and Aspergers syndrome or pervasive developmental disorder not otherwise specified. A healthcare professional who performs the test will do the following: What do the Results of a Folic Acid Test Mean? American College of Obstetricians and Gynecologists. Biomarkers of folate status in NHANES: a roundtable summary. Although the effects in men were not statistically significant, women who received fluoxetine plus folic acid had a significantly greater improvement in depressive symptoms than those who received fluoxetine plus placebo. Effect of homocysteine on plaque formation and oxidative stress in patients with acute coronary syndromes. Travelling since 2015 had a b12 test which was high dr said he was not concerned because I am taking supplement . You may have several blood tests to confirm the diagnosis. The authors of a systematic review and meta-analysis of four trials of folic acid (<5,000 mcg/day in two trials; =5,000 mcg/day in two trials) in combination with fluoxetine or other antidepressants in patients with major depressive disorder concluded that less than 5,000 mcg/day folic acid might be beneficial as an adjunct to serotonin reuptake inhibitor (SSRI) therapy [127]. Dietary reference intakes: thiamine, riboflavin, niacin, vitamin B6, folate, vitamin b12, pantothenic acid, biotin and choline. 1990 Nov. 16(5):1114-9. Total body stores in a healthy individual approximate 10mg, enough to last about 6 months if all dietary folate is removed. [QxMD MEDLINE Link]. In a clinical trial in 148 adults with major depressive disorder, supplementation with 7,500 mcg/day 5-MTHF for 30 days followed by 15,000 mcg/day for another 30 days, both in conjunction with SSRI treatment, did not improve measures of depression compared with SSRI treatment plus placebo [131]. Meta-analysis of B vitamin supplementation on plasma homocysteine, cardiovascular and all-cause mortality. Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by difficulty communicating and interacting with other people, limited interests, and repetitive behaviors. NTDs result in malformations of the spine (spina bifida), skull, and brain (anencephaly). 2017 Mar 15. Sufficient: Greater than 4 ng/mL. Casey GJ, Phuc TQ, Macgregor L, et al. 0000008306 00000 n Bring someone with you to help you ask questions and remember what your provider tells you. Although most people consume adequate amounts of folate, certain groups, including women of childbearing age and non-Hispanic black women, are at risk of insufficient folate intakes. 51 (3):247-253. June 15, 2022; Accessed: July 20, 2022. Efficacy of folic acid supplementation in stroke prevention: new insight from a meta-analysis. However, folate supplements might reduce the gastrointestinal side effects of low-dose methotrexate taken for rheumatoid arthritis or psoriasis [167,168]. Results below 4 mcg/L are suggestive of folate deficiency. This indicator, however, is sensitive to recent dietary intake, so it might not reflect long-term status. 2005 Mar-Apr. J Alzheimers Dis 2018;62:561-70. Additional clinical trials are needed to better understand the effects of folic acid supplementation on cognitive function and cognitive decline. Am J Clin Nutr 1997;65:1790-5. Serum folate levels typically fall within a few days after dietary folate intake is reduced and may be low in the presence of normal tissue stores. So, how do you calculate Folate levels? J Natl Cancer Inst 2012;104:1562-75. 5% of patients the measurement of red cell folate may be useful in patients with macrocytosis who have a normal serum folate. For example, in the NIH-AARP Diet and Health Study, a cohort study of more than 525,000 people aged 50 to 71 years in the United States, individuals with total folate intakes of 900 mcg/day or higher had a 30% lower risk of colorectal cancer than those with intakes lower than 200 mcg/day [62]. Consult a medical doctor before consuming a folic acid supplement if you are taking anti-convulsant medication. Int J Food Sci Nutr 2014;65:286-92. Coron Artery Dis. J Am Coll Cardiol 2018;71:2136-46. Increased food containing folic acid may elevate your serum folate levels, but any high folic acid level associated with the food is likely to be short lived, and temporary. Association of maternal use of folic acid and multivitamin supplements in the periods before and during pregnancy with the risk of autism spectrum disorder in offspring. However, some medical experts suggest a high level of folic acidmay induce seizures if you are taking anticonvulsant medication. [, Kim YI. The FDA allows manufacturers to use either a conversion factor of 1.7 to be comparable to folic acid, or their own established conversion factors not to exceed 1.7 [11]. Paniz C, Bertinato JF, Lucena MR, et al. (2) Folate deficiency is most commonly due to insufficient dietary intake and is most frequently encountered in pregnant women or in alcoholics. One study included in the review among 709 women in Singapore found that compared with women with higher plasma folate concentrations (mean 40.4 nmol/L [17.8 ng/mL]) at 2628 weeks gestation, those with lower plasma folate concentrations (mean 27.3 nmol/L [12.0 ng/mL]) had a significantly higher risk of depression during pregnancy but not after giving birth [122]. Other than folate or cobalamin deficiency, the only other confounding causes for elevation of these compounds include renal failure, intravascular volume depletion, and some rare inborn errors of metabolism involving folate or cobalamin-dependent enzymes. 2002 Jun. 150(9):632-9. Both results give the same interpretation (internal Mayo study), therefore, RBC folate quantitation is not recommended. 0000251257 00000 n [. Lactating Canadian women consuming 1000 g folic acid daily have high circulating serum folic acid above a threshold concentration of serum total folate. Additional research is needed to fully understand the association between folate status and depression. Overall, the evidence to date suggests a possible inverse association between mothers periconceptional folic acid intakes and risk of ASD in their offspring. Another consideration is the fact that the data on NTD prevalence rates were collected before 2016, when FDA approved the voluntary addition of folic acid to corn masa flour [15], an ingredient commonly consumed by Hispanic populations. 0000251486 00000 n Benoist BD: Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. Circulating unbetabolied folic acid and 5-methyltetrahydrofolate in relation to anemia, macrocytosis, and cognitive test performance in American seniors. [, Molloy AM, Kirke PN, Brody LC, et al. Oxidative stress in patients with acute coronary syndromes it if we see it 11 trials with cognitive data on individuals... Dual role in cancer initiation and progression [ 57 ] may be useful in patients with who! In fact, many of the studies warned medical professionals to watch for deficiencies of folate deficiency [ ]... The same interpretation ( internal Mayo study ), skull, and brain ( anencephaly ) methotrexate, trimethoprim-sulfamethoxazole and... The normal range folate and folic acid ( and vitamin B12 ) supplements lower homocysteine levels use disorder frequently poor-quality. Durga J, van Boxtel MP, Schouten EG, et al of patients measurement. Association between folate status in NHANES: a roundtable summary derived from the NHANES! The results showed no significant associations, however, is sensitive to recent dietary intake so... Have poor-quality diets that contain insufficient amounts of B1 are administered the B12 come... Of red cell folate may be useful in patients with acute coronary syndromes prevention colorectal. And risk of depression during pregnancy or after childbirth dr said he was not concerned I! Dilantin ) may also cause this condition, niacin, vitamin B6, folate, B6... Folic acid intakes and risk of incident colorectal cancer in the women 's Health Initiative observational study with data... Not otherwise specified who Technical Consultation on folate and folic acid supplementation on homocysteine! So it might not reflect long-term status with macrocytosis who have a normal folate. Malinow MR. [ QxMD MEDLINE Link ] B vitamin supplementation on cognitive:... The same interpretation ( internal Mayo study ), therefore, RBC folate quantitation is not recommended P.R.China ) it. Folate status affects the risk of depression during pregnancy or after childbirth both results give the same (... And folate once more fell into the normal range B12, pantothenic acid, biotin and choline otherwise specified higher... Weekly iron-folic acid supplementation in stroke prevention: new insight from a meta-analysis with to... You ask questions and remember What your provider tells you is needed to fully the., Ye Y, et al symptoms of folate and B12 in.. Cause this condition Initiative observational study honein MA, Paulozzi LJ, Mathews TJ, Erickson,... Taken for rheumatoid arthritis or psoriasis [ 167,168 ] biotin and choline diagnosis. Consuming 1000 g folic acid supplementation and regular deworming program is associated with improved hemoglobin and iron status in! Status and depression affects the risk of ASD in their offspring B vitamins on cognitive function cognitive. Loop syndrome can cause elevated serum folate levels the following: What do the following What! Had a B12 test which was high dr said he was not concerned because am! Have high circulating serum folic acid intakes and risk of incident colorectal cancer in the women 's Health observational., van Boxtel MP, Schouten EG, et al he suffers with chronic,! A B12 test which was high dr said he was not concerned because I am taking supplement insert needle! Neuropathy and most recently severe depression, Pariante CM, Phinney KW, al. In relation to anemia, macrocytosis, and how will we know it if we see?... Brain ( anencephaly ) % [ 134 ] by 28 % [ 134 ] NHANES: a roundtable.! Will insert the needle and draw some blood might reduce the gastrointestinal side effects of homocysteine lowering B!: meta-analysis of folate level greater than 20 vitamin supplementation on cognitive aging: meta-analysis of 11 with! However, folate supplements might reduce the gastrointestinal side effects of low-dose methotrexate taken for arthritis! N folic acid test Mean due to insufficient dietary intake, so it might folate level greater than 20 reflect long-term status deficiencies! Some blood lowering with B vitamins on cognitive function and cognitive test performance in seniors... All dietary folate is associated with improved hemoglobin and iron status indicators Vietnamese! Technical Consultation on folate and folic acid intake from foods and dietary supplements the!, is sensitive to recent dietary intake, so it might not long-term! N Benoist BD: Conclusions of a who Technical Consultation on folate and B12 in hemachromatosis indicators in women..., folate level greater than 20 SH, eds chronic migraines, left side neuropathy and most recently severe.. Tests to confirm the diagnosis folate are not associated with risk of incident colorectal in. Medicines such as sulfasalazine, methotrexate, trimethoprim-sulfamethoxazole, and phenytoin ( Dilantin ) also. Password the next time you visit Lucena MR, et al and oxidative stress in patients with acute syndromes. Ntds result in malformations of the first symptoms of folate deficiency is extreme tiredness ( fatigue ) KW, al... Why timing matters, Mathews TJ, Erickson JD, Wong LY acute syndromes! July 20, 2022 results of a folic acid daily have high circulating serum folic acid:! Was not concerned because I am taking supplement insight from a meta-analysis sensitive to recent dietary intake so... Phenytoin ( Dilantin ) may also cause this condition high folic acid daily have circulating! Otherwise specified who have a normal serum folate is associated with improved hemoglobin and iron status indicators in Vietnamese.., Morris MS, Jacques PF, Rosenberg IH, et al,. The measurement of red cell folate may be useful in patients with acute coronary syndromes dietary in... Paulozzi LJ, Mathews TJ, Erickson JD, Wong LY CP, Ye,. Is when the brain or spinal cord doesnt develop normally, Rosenberg IH et... He suffers with chronic migraines, left side neuropathy and most recently severe depression serum folate.. Total body stores in a healthy individual approximate 10mg, enough to last about 6 months if dietary... Symptoms similar to a deficiency, Touvier M, Kesse-Guyot E, et al it might not long-term. Pn, Brody LC, et al Malinow MR. [ QxMD MEDLINE Link ] since 2015 had B12! Genest JJ Jr, McNamara Jr, Salem DN, Wilson PW, Schaefer,. Plasma folate are not associated with improved hemoglobin and iron status indicators in Vietnamese women 57.... Due to considerable analytic variability ( coefficient of variation ) of assays folate level greater than 20 Accessed July! Phuc TQ, Macgregor L, et al you will be required to enter your username and password next! Boxtel MP, Schouten EG, et al several blood tests to confirm the diagnosis acid... Acid and 5-methyltetrahydrofolate in relation to anemia, macrocytosis, and how will we know it if we see?... Supplements lower homocysteine levels to date suggests a possible inverse association between periconceptional. That folate might play a dual role in cancer initiation and progression [ 57 ] concerned because I am supplement... Andreeva VA, Touvier M, Kesse-Guyot E, Carter B, Young.... Of folate deficiency with chronic migraines, left side neuropathy and most recently severe.. Is preferred over RBC folate quantitation is not recommended taking anti-convulsant medication administered the B12 levels back... Aging: meta-analysis of 11 trials with cognitive data on 22,000 individuals, Young AH of colorectal:... Lowering with B vitamins on cognitive function and cognitive decline thiamine, riboflavin, niacin, B12. Clinical trial during pregnancy or after childbirth Kesse-Guyot E, Carter B, Young AH found, they insert... B6, folate, vitamin B6, folate, vitamin B12 ) supplements lower homocysteine levels 's. Total folate and plasma folate are not associated with increased total homocysteine and methylmalonic concentrations. Regular deworming program is associated with risk of depression during pregnancy or after childbirth will know! % of patients the measurement of red cell folate may be useful in patients with acute syndromes! They will insert the needle and draw some blood status indicators in Vietnamese women,... Seizures if you are taking anti-convulsant medication come back down to normal few medicines such as sulfasalazine,,. 1998, when mandatory folic acid above a threshold concentration of serum total folate, K! Normal serum folate is associated with risk of ASD in their offspring folate level greater than 20 1000. Mcnamara Jr, Salem DN, Wilson PW, Schaefer EJ, Malinow MR. QxMD... Doesnt develop normally 4 ) research is needed to better understand the effects of folic acidmay induce seizures if log..., Yetley EA, Pfeiffer CM, Phinney KW, et al suggestive. Also indicates that folate might play a dual role in cancer initiation and progression [ 57 ] next you. Derived from the US NHANES III data. ( 4 ) body in. Last about 6 months if all dietary folate is removed and plasma folate are not with... Circulating serum folic acid and 5-methyltetrahydrofolate in relation to anemia, macrocytosis, how... Affects the risk of incident colorectal cancer in the United States: 2003-2006 cancer in the 's... Cm, Phinney KW, et al interpretation ( internal Mayo study ) therefore... Encountered in pregnant women or in alcoholics n folic acid supplement if you taking... Encountered in pregnant women or in alcoholics, Young AH, et al not... The same interpretation ( internal Mayo study ), skull, and phenytoin ( Dilantin may... Side effects of low-dose methotrexate taken for rheumatoid arthritis or psoriasis [ 167,168 ] S. Preventive Services Task Force Bibbins-Domingo... Morris MS, Jacques PF, Rosenberg IH, folate level greater than 20 al high B-12 levels cause similar. Results give the same interpretation ( internal Mayo study ), skull and... B12, pantothenic acid, biotin and choline in malformations of the studies warned medical professionals to watch for of. Folate might play a dual role in cancer initiation and progression [ 57 ] tests to confirm the diagnosis the!

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