My doctor wants me to take a Folic Acid supplement for a few months. Can it be that being Keto and not getting enough FRESH meat and eggs while backpacking is causing this. I eat a LOT of red meat and eggs at home but can go weeks at a time with low consumption of FRESH red meat and eggs when backpacking.
My normal level was 8 and it dropped to 7.4 two months after starting Keto and then to 5.4 eight months later (last week)
https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
This is an interesting article about how folate is measured. It also contains info about different foods and how much folate is in them. Unfortunately, most meat, except liver, does not have as much folate as certain vegetables.
I’ll just have to up my veggie consumption to what it was last year. I never did eat processed fortified foods - or al least not for the last decade.
I would suggest it’s your lack of fresh meat. Though I looked for my own values, and I cannot find any. In 5+ years of data, no one ever gave me this test.
There is also the question of how much folate a body needs on a ketogenic diet in the first place.
Yeah, I think for this one, if one is feeling well, maybe it’s better not to know what your value is? 
I only had folate tested because Platelet Count was borderline low and some other test was a little low and folate can be the reason for this. If you never get this test it’s because your other tests were good. I’ve only had it tested 4 times out of 20 labs
If you do choose to supplement make sure it is methylfolate and not folic acid (docs usually recommend regular folic acid). Most humans don’t do the conversion well and folate is the active form and they can compete for the same receptors and cause more issues.
Do you have links to articles on this? I thought that if I had this mutation I would not have had normal levels of B12 or previous normal levels of folate. If it does not return to normal in three months then homocysteine can be tested. Taking folic acid and having folate not return to normal would be the test . . .
I don’t have links on hand but I know I’ve seen many cases of non optimal conversion (not zero!) without the mutation you’re referring to. You’re right that it would be a chronic issue if you had that mutation.
As of my last test, my platelet count was slightly low too (138, low is 140). Do you know what else they were looking at?
Some interesting things about Folic Acid and Folate:
[1] “…The majority of the pre-packaged. foods found in the grocery store have been through this process and fortified with folic acid. This is bad news for people with the MTHFR mutation. People with this mutation are unable to rid their bodies of folic acid. It builds up, blocking folate receptors and wrecking havoc. This build up is known as folic acid toxicity. Most lab tests do not distinguish between folic acid and folate when measuring blood levels. If folic acid intake is high, the results may show an individual has adequate amounts of folate. This is misleading as the individual actually has high levels of unusable folic acid, with little to no folate. This situation can cause the body to believe it is malnourished and result in unnecessary storing of energy (weight gain) bodies of folic acid. It builds up, blocking folate receptors and wrecking havoc. …More
[2] Folate-Related Polymorphisms:
Folate is found in dark green leafy vegetables like spinach and it serves two very important functions in the body. First, folate serves as a precursor to make new DNA. This is important for repairing a damed cell and for producing new cells whether we are talking about a sperm cell, or a brain cell (Figure 2). Second, folate serves as a precursor to make epigenetic factors, which change how much of a gene a given cell produces so that the gene does either more or less of a certain function. Epigenetics is discussed in more detail below.
There are a cluster of common polymorphisms in the folate metabolism pathway that affect the way the body metabolizes folate. These polymorphisms are in a gene known as MTHFR and can decrease its function between 40-90% (Figure 2). I have discussed MTHFR polymorphisms in a previous video. Supplementation with L-methylfolate along with other B vitamins has been shown to help overcome the MTHFR deficit . …”
Figure 2: Folate Metabolism Pathway
Folate is converted into tetrahydrofolate, which is converted into 5,10-methylenetetrahydrofolate is required for two important pathways: 1). The synthesis of nucleic acids (thymine) required to make new DNA. 2). The production of 5-methylfolate by the riboflavin-dependent methylenetetrahydrofolate reductase (MTHFR) enzyme. The methyl group from 5-methylfolate is used to convert homocysteine into the essential amino acid methionine (via methylation) by the vitamin B12-dependent methionine synthase enzyme. Methionine, is now methylated and is used as methyl donor via methyl transferase enzymes for a broad range of methylation reactions involved in epigenetics (DNA methylation). Once the methyl group is used from SAM, the methionine forms homocysteine again and the cycle starts over. * …More
[3] “…Beef liver is one of the most concentrated sources of folate available. A 3-ounce (85-gram) serving of cooked beef liver packs 212 mcg of folate, or about 54% of the RDI (30). In addition to folate, a single serving of beef liver can meet and exceed your daily requirements for vitamin A, vitamin B12 and copper (30). …” …More
[4] “…On the other hand, folic acid is a synthesized version of vitamin B9 that is added to processed foods and the common version used in supplements. Folic acid has a molecular structure that is nearly identical to folate. Due to their close resemblance, folic acid and folate are widely considered to be the same. …” …More
Funny thing is . . . since going Keto I started taking 4-6 desicated liver tablets a day but maybe that’s one item that does not survive the drying (seeing it’s a water soluble vitamin)
My second round of tests they took were:
RETICULOCYTES/100 RBC’S, AUTO
RETICULOCYTES, IMMATURE/RETICULOCYTES, TOTAL, RBC
RETICULOCYTE HEMOGLOBIN CONTENT
RBC
All of which were normal
The ones bulletpointed were tested twice and they all improved on the second test.
I should also say that I give blood the maximum times per year I can, so that may have an effect, too.
Hmmm! Maybe it is just your levels at the time they were taken? They are not static (they are dynamic)?
Etiology
”…Folic acid deficiency can arise from multiple causes including inadequate dietary intake. Heating during cooking destroys folic acid. Folate is absorbed in the jejunum by active and passive transport mechanisms across the intestinal wall. Hence, diseases such as celiac disease, tropical sprue, short bowel syndrome, amyloidosis, gastric bypass or mesenteric vascular insufficiency can inhibit folate absorption resulting in a deficiency. Elevated pH as occurs in achlorhydria can also lead to poor folate absorption. Drugs such as methotrexate, phenytoin, sulfasalazine, and trimethoprim can antagonize folate utilization, inhibit its absorption or conversation to its active form resulting in folate deficiency. Congenital deficiencies of enzymes required in folate metabolism can lead to folate deficiency. Folic acid deficiency can occur subsequent to vitamin B-12 deficiency due to an impairment of methionine synthase resulting in the trapping of folate as methyltetrahydrofolate whereby methylene THFA accumulates in serum leading to folate trap phenomenon and increased urinary excretion of folate. Alcoholism is a significant cause of folate deficiency. Pregnancy, hemolytic anemia, and dialysis can also result in folate deficiency. …” …More
If the level in blood is dropping, that is a problem. If the nutritional intake is lower but blood levels are normal or rising, bioavailability is improving and there is no problem.