Simple, cheap and genuinely important — with one rule about B12 that must not be skipped.
Explained by a GMC-registered GP, not a leaflet
Honest about what we can and cannot prescribe remotely
Side effects given the same weight as benefits
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Folic acid is the synthetic form of folate — vitamin B9 — which the body needs to build DNA and to make red blood cells.
Its best-known role is in pregnancy. Taking folic acid before conception and in early pregnancy substantially reduces the risk of neural tube defects such as spina bifida — one of the clearest and most valuable preventive findings in modern medicine.
The timing is what makes it work. The neural tube closes by about week four, frequently before a pregnancy is recognised — so folic acid started when a pregnancy is confirmed has largely missed its window.
That list covers a lot of people, and the higher dose is frequently not offered. It is worth asking.
Usually 5mg once weekly, on a different day from the methotrexate. Taking them on the same day reduces the methotrexate's effect.
5mg daily for four months, longer where the cause persists.
Folic acid is very well tolerated.
The important risk is not a side effect but a diagnostic one — see below.
Folic acid can correct the anaemia of B12 deficiency while allowing the neurological damage to continue — and that damage can be permanent.
Both deficiencies cause the same type of anaemia, so the blood count improves and everyone is reassured, while nerve damage progresses silently.
This is why B12 must be checked before starting folic acid for anaemia, and treated first if low. It is a genuine and avoidable harm, and it is the single most important point on this page.
Check B12 and folate together, always — never folate alone when investigating anaemia.
Full blood count to confirm the anaemia is responding. Where deficiency is found, the question is why — diet, coeliac disease, alcohol, or malabsorption.
Yes — though the standard pregnancy dose is available cheaply from any pharmacy, so a prescription is rarely worth paying for.
Where a consultation genuinely helps:
The 5mg dose is not something to self-select, and equally it is frequently not offered to people who should have it.
400 microgram folic acid is sold in every pharmacy and supermarket for very little, and is included in pregnancy multivitamins.
The 5mg strength requires a prescription and is also inexpensive.
In the UK, folic acid is now added to non-wholemeal wheat flour — a public health measure introduced because so many pregnancies are unplanned that supplementation alone was never going to reach everyone. It does not replace taking a supplement if you are trying to conceive.
Beware pregnancy multivitamins containing vitamin A as retinol, which should be avoided in pregnancy.
In pregnancy, stop at the end of week 12 — the neural tube has closed and there is no benefit to continuing, though it does no harm and many people continue a pregnancy multivitamin.
Vitamin D should continue throughout pregnancy and breastfeeding, which is a separate recommendation and often confused with this one.
For deficiency, treatment continues until corrected and the cause addressed.
Leafy green vegetables, pulses, and fortified cereals are good sources — the word folate comes from folium, a leaf. But diet alone cannot reliably deliver enough for pregnancy, which is why the supplement is recommended universally rather than selectively.
At least a month before you conceive. The neural tube closes by about week four, often before you know you are pregnant — which is why starting it when a test is positive largely misses the point.
5mg if you have diabetes, a BMI of 30 or above, take anti-epileptic medication, have coeliac disease, or have a personal or family history of neural tube defects. That is a lot of people, and it is worth asking rather than assuming.
Because folic acid can fix the anaemia of B12 deficiency while nerve damage continues — and that damage can be permanent. Always test both together.
Start now, and do not panic. The greatest benefit is early, but the overall risk remains low and worrying about it changes nothing. Mention it at your first midwife appointment.
Yes, in the UK now — but at levels designed to raise the population average, not to replace a supplement. Keep taking it if you are trying to conceive.
It reduces methotrexate's side effects — mouth ulcers, nausea, liver upset. Take it on a different day, or it blunts the methotrexate itself.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
On this page
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
Patient reviews
