Whats the next step if folic acid is still low in a male after treatment? had 5mg daily for 4 months but still very lethargic

Increase dose: I believe that you should take a higher dose- perhaps prescription strength. I also would question that this is the sole reason for your fatigue and I recommend that you visit your physician for a thorough history and system review as well as a complete physical examination. Appropriate tests can be ordered based on the assessment.