High Folate Levels

[Tyoung]

I was diagnosed in November with celiacs and at the time had been tested for multiple vitamin deficiencies. During that time my folate level was 4ng/mL, Although I was told to take supplements, I ended up only taking them for a week or so as they made my stomach upset. I had my blood work redone yesterday and as the results came in I noticed that most of my levels are now normal, but folate level is >24ng/mL. Has anyone else had similar results? If so were you able to figure out why or how to normalize them? I also have been having constant acid reflux since about two weeks into going gluten free (no acid reflux history prior to) that we are trying to get to the bottom of with no answers. Could that be related? Thank you!!

Also wanted to not that I am not eating any gluten free processed food.

[trents]

Welcome to the forum, @Tyoung!

Apparently, folic acid in supplements is readily absorbed into the bloodstream as opposed to getting folate from natural food sources. So, high levels in the blood can happen quickly from supplementation:

Your body doesn’t absorb folate as easily as it absorbs folic acid.

It’s estimated that about 85% of folic acid from fortified foods or supplements is absorbed, while only 50% of natural folate from foods is used by your body.

After folic acid is absorbed into your bloodstream, it’s broken down into smaller compounds by your liver. However, the liver is only able to process a certain amount of folic acid at a time.

As a result, consuming too much folic acid from fortified foods and supplements can cause unmetabolized folic acid (UMFA) to accumulate in your blood. This doesn’t happen when you eat high folate foods.

From: https://www.healthline.com/nutrition/folic-acid-side-effects#How-excess-folic-acid-develops

I would think your folate levels will normalize over time. But I'm curious. Were you tested for vitamin/mineral deficiencies before being given supplements or was it just assumed you would have them after finding out you have celiac disease?

Your acid reflux issues could certainly be a holdover from the week of supplementation now discontinued. Another possibility is "gluten withdrawal" which some experience in the first few weeks after going gluten free. Gluten has addictive qualities similar to opiates. Another possibility is certain polysaccharides commonly found in gluten free prepackaged facsimile foods. They use these polysaccharides (e.g., xanthan gum) as texturing agents to approximate what gluten does in wheat products and they are hard to digest.

Let me caution you against long term proton pump inhibitor (PPI) therapy for the acid reflux. That simply raises gut PH (lowers acidity) which interferes with the absorption of vitamins and minerals from our diets. Way too often, docs will prescribe PPIs as a band aid for reflux and leave their patients on them forever. It's much better to use over the counter calcium-based remedies like TUMS to give you coverage as needed rather than treat reflux systemically with acid blockers.

Edited March 12, 2025 by trents

[Scott Adams]

It sounds like you’ve been through a lot since your celiac diagnosis, and it’s great that you’re paying close attention to your health and lab results.

Regarding your folate levels, it’s interesting that they’ve jumped from 4 ng/mL to >24 ng/mL. Since you mentioned you only took supplements for a short time, it’s possible that your diet changes since going gluten-free have played a role. Whole foods like leafy greens, legumes, and certain fruits are naturally high in folate, and if you’ve been eating more of these, they could have contributed to the increase. However, such a significant jump might also warrant a discussion with your doctor to rule out other factors, like how your body is absorbing nutrients post-diagnosis.

As for the acid reflux, it’s not uncommon for people to experience new digestive symptoms after going gluten-free, especially if their gut is still healing. Celiac disease can cause inflammation and damage to the digestive tract, and as your body adjusts to a gluten-free diet, it might take time for things to settle. Some people also find that removing gluten can shift their gut microbiome, which might temporarily lead to issues like acid reflux. It’s good that you’re avoiding processed gluten-free foods, as they can sometimes be harder to digest. You might want to explore whether other foods (e.g., dairy, acidic foods, or high-fat meals) are triggering the reflux.

A few things you could consider:

• Keep a Food Diary: Track what you eat and any symptoms to identify potential triggers.
• Smaller, Frequent Meals: Eating smaller portions more often can sometimes ease acid reflux.
• Probiotics: These might help balance your gut microbiome as it adjusts to the gluten-free diet.

Follow-Up with Your Doctor: Since your folate levels and acid reflux are both notable, it’s worth discussing these changes with your healthcare provider. They might want to check for other underlying issues or adjust your treatment plan.