Folate Deficiency | Treatment and Prevention | Nutrition

Folate deficiency

What is folate deficiency?

Folate deficiency anemia is a lack of folic acid in the blood. Folic acid is a B vitamin that supports your body to produce red blood cells. If you don’t have sufficient red blood cells, you have anemia.

Folate or folic acid is a kind of vitamin B. It helps to:

  • Make DNA
  • Repair DNA
  • Produce red blood cells (red blood cells)

If you don’t have enough folate in your diet, you can end up with a folate deficiency. Certain beverages and foods, such as citrus juices and dark green vegetables, are particularly good sources of folic acid.

Not eating enough folate in just a few weeks that can lead to a deficiency. Deficiency can also occur if you have a disease or genetic mutation that prevents your body from absorbing or converting folate to its usable form.

Folate deficiency can cause anemia. Anemia is a condition in which you have very few red blood cells. Anemia can deprive the tissues of the oxygen it needs because red blood cells carry oxygen. This can affect its function.

Folate is particularly significant in women of childbearing age. A folate deficiency throughout pregnancy can lead to birth defects.

Most people get enough folic acid from food. Many foods now have extra folate in the form of folic acid, a synthetic version of folate, to prevent deficiency. However, supplements are recommended for women who may become pregnant.

Causes of folate deficiency

Folic acid (vitamin B9) works with vitamin B12 and vitamin C to assistance the body break down, use, and make new proteins. The vitamin B assistances to form red and white blood cells. It also helps to make DNA, the building block of the human body, which carries genetic information.

Folic acid is a type of water-soluble vitamin B. This means that it is not stored in the fatty tissues of the body. Leftover amounts of the vitamin leave the body through urine.

Because folate is not stored in large amounts in the body, your blood levels will drop after a few weeks of eating a low-folate diet. Folate is mainly found in legumes, green leafy vegetables, eggs, beets, bananas, citrus fruits, and liver.

Contributors to folate deficiency include:

  • Diseases in which folic acid is not well absorbed from the digestive system (such as celiac disease or Crohn’s disease)
  • Drinking too much alcohol
  • Eating overcooked fruits and vegetables. Folate can be easily destroyed by heat.
  • Hemolytic anemia
  • Certain medications (such as phenytoin, sulfasalazine, or trimethoprim-sulfamethoxazole)
  • Eating an unhealthy diet that doesn’t include enough fruits and vegetables.
  • Kidney dialysis

Risk factors

Risk factors for folate deficiency include:

  • Malnutrition or not eating a varied diet that includes fruits, vegetables, and fortified foods
  • Have an alcohol use disorder or drink large amounts of alcohol regularly
  • Be a woman of childbearing age
  • Be pregnant
  • Have a malabsorption disorder
  • Having the MTHFR polymorphism gene variation that interferes with the way the body uses folate
  • Taking certain medications, including methotrexate, anti-seizure medications, and some medications that treat ulcerative colitis

Symptoms of folate deficiency

Folic acid deficiency can cause:

  • Fatigue, irritability, or diarrhea
  • Poor growth
  • Soft and tender tongue

Diagnosis of folate deficiency

To look for folate deficiency anemia, your doctor will ask about your symptoms. They may also order blood tests and a complete blood count (CBC) test to measure the number and appearance of your red blood cells. If you are lacking in folic acid, your red blood cells look large and immature.

Treatment for folate deficiency

Your healthcare provider will determine the best treatment based on:

  • Your age, general health, and medical history
  • How sick are you?
  • How well you can handle certain medications, treatments, or therapies?
  • How long the condition is expected to end?

Your opinion or preference

Treatment may include:

  • Vitamin and mineral supplements
  • Changes in your diet
  • Medicine
  • Treat the underlying disease

You may essential to take folic acid supplements for at least 2 to 3 months. They can be pills or injections (injections). It is also important to eat foods that are high in folic acid and reduce your alcohol intake. If a digestive tract problem is causing your anemia, your provider can treat it first.


Folate deficiency anemia during pregnancy can cause a neural tube defect. This is when the brain or spinal cord does not develop normally. It can cause death before or shortly after birth. Or it can cause paralysis of the legs.


Taking a folic acid supplement and eating a healthy diet will prevent many cases of folate deficiency anemia.

People who have risk factors for folate deficiency should consult a doctor about the correct amount of folic acid to take.

A person can also prevent folate deficiency anemia by eating foods that are rich in folate or that manufacturers have fortified with folic acid.

Folate is found naturally in many foods, including:

  • Spinach
  • Romaine lettuce
  • Brussels sprouts
  • Asparagus
  • Avocado
  • Beans

To make it easier for people to meet their requirements for folic acid, beginning in 1998, the Food and Drug Administration (FDA) requires food manufacturers to add folic acid to standardized fortified cereal products, such as fortified bread.

Products that manufacturers often fortified with folic acid include flours, breakfast cereals, and other cereal products. These fortified foods are a decent source of folic acid in the diet.

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