Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisComplicationsTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Complications
Treatment
A folate deficiency is a lack of vitamin B9 (folate). Folate is a water-soluble vitamin that can only be taken into the body through foods and supplements. The body uses folate to create and repair DNA (the genetic material inside cells) and to produce red blood cells, which carry oxygen throughout the body.
This article will discuss the symptoms, causes, diagnosis, and treatment for a folate deficiency.
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Folate Deficiency Symptoms
The early signs of a folate deficiency can be subtle, and it’s common for it to go undiagnosed. Signs and symptoms of a folate deficiency may include:
When left untreated, more symptoms can develop, and they may become more severe. Less common and potentially severe symptoms of a folate deficiency may include:
What Vitamin Deficiency Might Cause You to Feel Cold?
Causes of Folate Deficiencies
Folate is a water-soluble vitamin. This means it’s absorbed and transported in water. If you consume more water-soluble vitamins than your body can use in a day, your kidneys filter out the extra in urine.
Unlike other types of water-soluble vitamins, a small amount of folate can be stored in the liver. A deficiency could develop in weeks to months on a diet that doesn’t provide folate.
Here are potential causes of a folate deficiency:
Diet
If you don’t consume enough folate from your diet, you can develop a deficiency. Folate is found in fruits, vegetables, nuts, eggs, and some types of seafood. Some foods are fortified with a synthetic form of folate, calledfolic acid.
In addition, the heat used during cooking may destroy some of the folate and decrease the amount provided in your diet. Folic acid is added to grain products like flour, bread, cereal, pasta, rice, and cornmeal.
Digestive Diseases
Medical conditions that affect the digestive system can interfere with your body’s ability to digest and absorb folate. These can include:
Kidney Failure and Dialysis
People undergoing dialysis treatments should be monitored for deficiencies and take additional vitamins as needed.
Genetics
Before the body uses folate, it converts folate into an active form called methylfolate. Some genetic mutations, like the MTHFR gene, can interfere with converting folic acid into its active form.
This means that if you have the MTHFR gene, you could develop a folate deficiency even if you’re eating foods fortified with folic acid or taking a folic acid supplement.
Excessive Alcohol Intake
Drinking too much alcohol can interfere with digestion and absorption of nutrients. Research shows that folate deficiencies are common among people withalcohol use disorder.
Medication Side Effects
Some medications may lead to a folate deficiency, such as:
Folate deficiencies are diagnosed with a blood test to assess folate levels and the health of red blood cells. If your healthcare provider suspects a folate deficiency, they may order blood tests like:
It’s common for folate levels to be checked during pregnancy to monitor for a deficiency since it can lead to complications.
If left untreated, a folate deficiency in pregnancy can lead to complications like:
Neural Tube DefectsNeural tube defects areskull birth defectsand defects along the lower spine. Three types are anencephaly (parts of the brain and skull do not form), encephalocele (sac-like protrusion of the brain and its membranes), andspina bifida(vertebrae do not form correctly around the spinal cord).
Neural Tube Defects
Neural tube defects areskull birth defectsand defects along the lower spine. Three types are anencephaly (parts of the brain and skull do not form), encephalocele (sac-like protrusion of the brain and its membranes), andspina bifida(vertebrae do not form correctly around the spinal cord).
Treatment for a folate deficiency includes increasing intake of folate or folic acid. People without theMTHFR gene mutationcan meet their needs with either folate or folic acid in supplements or foods.
But people who have the mutation should focus on consuming folate foods or specific types offolate supplements(since they can’t convert folic acid into its active form).
Since the neural tube develops in the first few weeks of pregnancy (before most people know they’re pregnant), it’s recommended that all people who are capable of becoming pregnant take a folate supplement.
It’s recommended for most people to consume 400 micrograms of folate per day.
Some of the foods high in folate include:
Folic acid is added to fortified grains like:
Summary
A Word From Verywell
At first, it can be difficult to notice the symptoms of a folate deficiency. But once you’re aware of it, the deficiency can be simple to treat through increasing foods and supplements. If you suspect you have a nutrient deficiency, it’s best to talk with your healthcare provider to confirm the diagnosis.
17 Sources
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Johns Hopkins Medicine.Folate-deficiency anemia.
Ebara S.Nutritional role of folate.Congenit Anom (Kyoto). 2017;57(5):138-141. doi:10.1111/cga.12233.
O’Connor DMA, Scarlett S, De Looze C, O’Halloran AM, Laird E, Molloy AM, Clarke R, McGarrigle CA, Kenny RA.Low folate predicts accelerated cognitive decline: 8-year follow-up of 3140 older adults in Ireland.Eur J Clin Nutr. 2022 Jan 13. doi:10.1038/s41430-021-01057-3
Allott K, McGorry PD, Yuen HP, et al.The Vitamins in Psychosis Study: a randomized, double-blind, placebo-controlled trial of the effects of vitamins B12, B6, and folic acid on symptoms and neurocognition in first-episode psychosis.Biol Psychiatry. 2019;86(1):35-44. doi:10.1016/j.biopsych.2018.12.018
Bender A, Hagan KE, Kingston N.The association of folate and depression: A meta-analysis.J Psychiatr Res. 2017;95:9-18. doi:10.1016/j.jpsychires.2017.07.019.
Attia AAA, Amer MAEM, Hassan M, Din SFG.Low serum folic acid can be a potential independent risk factor for erectile dysfunction: a prospective case-control study.Int Urol Nephrol. 2019;51(2):223-229. doi:10.1007/s11255-018-2055-y.
Scaglione F, Panzavolta G.Folate, folic acid and 5-methyltetrahydrofolate are not the same thing.Xenobiotica. 2014;44(5):480-488. doi:10.3109/00498254.2013.845705.
Ponziani FR, Cazzato IA, Danese S, et al.Folate in gastrointestinal health and disease.Eur Rev Med Pharmacol Sci. 2012;16(3):376-385.
Samodelov SL, Gai Z, Kullak-Ublick GA, Visentin M.Renal reabsorption of folates: pharmacological and toxicological snapshots.Nutrients. 2019;11(10):2353. doi:10.3390/nu11102353
Sanvisens A, Zuluaga P, Pineda M, et al.Folate deficiency in patients seeking treatment of alcohol use disorder.Drug Alcohol Depend. 2017;180:417-422. doi:10.1016/j.drugalcdep.2017.08.039.
Vidmar M, Grželj J, Mlinarič-Raščan I, Geršak K, Dolenc MS.Medicines associated with folate-homocysteine-methionine pathway disruption.Arch Toxicol. 2019;93(2):227-251. doi:10.1007/s00204-018-2364-z
De Bruyn E, Gulbis B, Cotton F.Serum and red blood cell folate testing for folate deficiency: new features?Eur J Haematol. 2014;92(4):354-359. doi:10.1111/ejh.12237.
Socha DS, DeSouza SI, Flagg A, Sekeres M, Rogers HJ.Severe megaloblastic anemia: vitamin deficiency and other causes.Cleve Clin J Med. 2020;87(3):153-164. doi:10.3949/ccjm.87a.19072.
Huguenin A, Barraud S, Daliphard S, Marot D, Garnotel R, Bani-Sadr F.Severe pancytopenia due to acute folate deficiency despite normal folate erythrocyte level.Ann Biol Clin (Paris). 2016;74(3):313-316. doi:10.1684/abc.2016.1137.
Office of Dietary Supplements.Folate. Fact sheet for health professionals.
Henry CJ, Nemkov T, Casás-Selves M, et al.Folate dietary insufficiency and folic acid supplementation similarly impair metabolism and compromise hematopoiesis.Haematologica. 2017;102(12):1985-1994. doi:10.3324/haematol.2017.171074
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