Does anyone know why my 12-year-old daughter would have low folate?

[iwishiwasonacruise]

Just as a bit of background, my daughter is 12, almost 13, she started her period when she was 10, in case that's relevant, she also gets her period every 21 days, which is obviously quite often. A year ago she had a blood test which said she had low iron. She has been taken Floradix liquid since then.

Just lately she has had lots of lightheadedness, headaches, vision problems (her eyes have been checked by an optician), and generally feeling a bit low and fed up. She also looks very pale.

I've asked them to repeat the blood test, and the GP surgery called and said even though her iron level has improved since last year, she now has low folate. I wanted a proper GP appointment to discuss this with them, but I can't get one for 10 days.

I am interested to know why she might have low folate, and what I can do about this in future.

Obviously I will get proper advice at the appointment I've got in 10 days, but was hoping for any insight in the meantime.

They have prescribed a four month course of liquid folic acid. I've been told she can take this as well as the Floradix.

I just want her to feel better. When I google low folate, it does match up with a lot of her recent symptoms, so I'm hoping the folic acid will help.

I asked the receptionist for a printout of both sets of bloods, but I'm not allowed this until I've seen the doctor. But she did tell me that her folate should be - I think - between 7 and 10, and hers was 3.2.

Many thanks if anyone can shed any light while I'm waiting for a chat with the doctor.

I meant to say that she has a decent diet as well. Obviously not perfect, as she's 12 years old, and does occasionally have a beige dinner, but she eats lots of fruit and veg, she's a pasta fiend! lots of chicken, some red meat, quite a good variety, she hasn't got a massive sweet tooth so only has a bit of chocolate or a biscuit occasionally. Mostly drinks water or a cup of tea with me, so I'm hoping it's not diet related.

So it sounds like she's not absorbing it from food properly. This nonabsorption can be because of inflammation, like if she has food intolerances (possibly to all the pasta!) but this can be exceedingly difficult to narrow down yourself because symptoms can take time to appear, sometimes only in combination with other sensitivities and they do start mild... see if the tablets help. Not everybody is able to metabolise folic acid properly so she may need methylfolate not folic acid. If no improvement and the doc has no ideas, I would look into getting a food allergy and intolerance test. It's common for this to start showing up in early teens.

I think you should query whether she has coeliac disease or crohn's disease.

Low iron and foliate are common in these conditions because micronutrients can't be absorbed because of damage to the intestine. The light-headedness, paleness and vision impairment might also be a sign.

I used to know a lot about this because of my previous career but wouldn't feel comfortable in saying for sure nowadays. I would definitely ask for this side of things to be checked out though.

Unlikely to be Crohn's. My DD has it and was obviously unwell for months - permanent diarrhea, weight loss, random fevers, vomiting sporadically, breathless, no energy.

Coeliac might be a good call though. Worth the blood test.

And don't use the word intolerance when you speak to your GP. It's so vague, goes hand-in-hand with neurotic parenting and means almost nothing to some medical professionals. There's clearly a proper medical issue here so stick to clear medical terminology.

My niece, who is in her 20s, has actually recently been diagnosed as coeliac, and my brother and sister-in-law are in the process of getting tested as well, because as far as I know, this can run in families, so the coeliac link could be interesting.

However, my sister-in-law thinks it's unlikely as my daughter's iron levels have improved with the Floradix, whereas when my niece started taking iron, before she knew she was coeliac, they just couldn't get her levels up at all.

But it's definitely worth looking into.

Thanks for the suggestions :)

I would tell the GP about the Crohn's in your other daughter. It might be worth testing anyway. It can present differently in different people depending on severity and where it is. Good luck x

I have a niece who is coeliac, not another daughter with Crohn's, I think it's been confused with another poster :) but thank you for the post anyway. When I speak to the GP I will definitely mention about my niece having been diagnosed as coeliac. I assumed the family link with coeliac would be within immediate family, ie a family unit, but there is every chance that's completely wrong.

It's me with the DD with Crohn's, not the OP. Funnily enough there is masses of coeliac in my family.

My grandparents had two daughters.

One is my mum who has one coeliac child (not me) and a granddaughter with Crohn's.

My aunt has 3 kids, two are coeliac. They have 5 kids between them; two of them are also coeliac.

So it can definitely be dispersed in the family!

Thank you so much for the clarification. I will definitely be raising this with the GP. I suppose I will start her on the folic acid and then ask for the blood test to be repeated in a month or two. Hopefully they will agree to test her for coeliac at the same time.

That’s not necessarily the case. A percentage of people are diagnosed on the basis of tests after presenting with extra intestinal problems with their eyes, skin or joints well before they ever display any gut issues. The ops dd is feeling unwell, has eye problems, and is clearly not absorbing nutrients the way she should which would suggest a gut issue too even if it isn’t causing her what we think of as typical crohn’s or ulcerative colitis symptoms.

I think it would be a good idea to ask if they might check her B12 levels too op, as it’s very possibly low too if her gut isn’t absorbing folate. They could also check for raised inflammatory markers in her blood (CRP and ESR) and, ideally, stool (facial calprotectin test) to look at might be causing the problem as well as for coeliacs.

Eye problems in Crohn's are more often Physical though - redness and pain - aren't they? Rather than vision problems.

I mean, yes sensible to check but I still think it doesn't sound very likely.