Takeaways
- Folate is essential for DNA synthesis and cell division
- Deficiency can lead to anemia and neurological problems
- Pregnant women need extra folate to prevent birth defects
- Diet and supplements can correct most cases of deficiency
- Regular screening helps catch low folate levels early
Understanding Folate
Folate, a B vitamin essential for bodily functions, plays a key role in creating DNA and other genetic components.[1] Working with vitamin B12, folate also assists in the formation of healthy red blood cells.[2] Since the body cannot produce folate, it must be obtained through food or supplements.[3]
While both folate and folic acid are forms of vitamin B9, they differ in origin. Folate is the naturally occurring form found in foods, while folic acid is a synthetic version used in supplements and fortified foods.[4] The body tends to absorb folic acid more readily than the folate found in food.[5]
The recommended daily amount of folate varies based on age and life stage, with adults needing about 400 micrograms.[6] During pregnancy, women should aim for 600 micrograms to support the developing fetus.[7] Breastfeeding mothers need around 500 micrograms daily.[8]
Good food sources of folate include:
- Dark green leafy vegetables
- Beans and lentils
- Citrus fruits
- Eggs
- Fortified grains and cereals
Causes of Folate Deficiency
Low folate levels in the body can be caused by several factors. A diet lacking in folate-rich foods is a common reason, while certain medical conditions and medications can also disrupt folate absorption or how it’s used by the body.[9]
Diet significantly impacts folate levels. Consuming primarily processed foods and few vegetables can lead to a deficiency.[10] Overcooking vegetables can destroy folate, and excessive alcohol use can hinder folate absorption, further increasing deficiency risk.[11]
Certain health conditions elevate the risk of folate deficiency. Celiac disease and inflammatory bowel diseases can impair nutrient absorption, and kidney dialysis patients often have low folate levels.[12] Medications like methotrexate and some anti-seizure drugs can also deplete folate.[13]
Top risk factors for folate deficiency:
- Poor diet low in folate-rich foods
- Heavy alcohol use
- Malabsorption disorders
- Pregnancy without proper supplementation
- Certain medications
Symptoms and Health Consequences
Early Signs
Initially, low folate levels often cause subtle symptoms, like unusual tiredness or weakness.[14] Some may experience headaches or difficulty focusing, while mood changes, such as irritability or depression, are also possible.[15]
These early symptoms result from folate’s importance in energy production and brain function. Without adequate folate, cells struggle to grow and divide properly, which can affect various body systems and produce a range of symptoms.
Long-term Effects
Long-term folate deficiency can lead to serious health problems, including anemia.[16] This condition, which occurs when the body’s red blood cell count is low, reduces oxygen delivery throughout the body and causes symptoms like fatigue and weakness.
Folate deficiency anemia leads to symptoms like:
- Pale skin
- Shortness of breath
- Dizziness
- Rapid heartbeat
Severe folate deficiency can damage the nervous system, potentially causing numbness or tingling in the hands and feet.[17] In very serious cases, confusion, memory issues, and depression can develop.[18]
| Mild Deficiency Symptoms | Severe Deficiency Symptoms |
|---|---|
| Fatigue | Anemia |
| Weakness | Shortness of breath |
| Headaches | Neurological symptoms |
| Irritability | Cognitive impairment |
Folate’s Role in Pregnancy
Folate is crucial during pregnancy, supporting the proper development of the fetus.[19] It is vital for forming the neural tube, which develops into the baby’s brain and spinal cord.[20] Sufficient folate intake significantly reduces the risk of serious birth defects.[21]
Neural tube defects, birth defects affecting the brain and spine, occur when the neural tube does not close correctly in early pregnancy.[22] Adequate folate intake can prevent up to 70% of these defects.[23]
Pregnant women need 600 micrograms of folate daily to support the rapid cell growth and division in the developing fetus, which helps prevent birth defects.[24] Ideally, women should start taking extra folate before they become pregnant.
Ways to ensure adequate folate intake during pregnancy:
- Take a prenatal vitamin with folic acid
- Eat folate-rich foods daily
- Consider a separate folic acid supplement
- Avoid alcohol, which interferes with folate absorption
Diagnosing Folate Deficiency
Doctors use blood tests to diagnose folate deficiency.[25] A serum folate test measures the amount of folate in your blood, while a red blood cell folate test shows long-term folate levels.[26]
Normal serum folate levels are above 3 nanograms per milliliter (ng/mL), while levels below 2 ng/mL suggest a deficiency.[27] Red blood cell folate should be above 140 ng/mL; lower levels indicate chronic folate deficiency.[28]
Your doctor may order additional tests to investigate related issues. A complete blood count can help detect anemia, while vitamin B12 levels are often checked alongside folate to distinguish between different types of anemia.
| Test | Normal Range | Deficient Range |
|---|---|---|
| Serum Folate | > 3 ng/mL | < 2 ng/mL |
| RBC Folate | > 140 ng/mL | < 140 ng/mL |
Treatment Options
Dietary Changes
Mild folate deficiency can often be corrected by increasing consumption of folate-rich foods.[29] Focusing on including more vegetables, fruits, and legumes in meals can provide natural folate, as well as other important nutrients.[30]
Make an effort to include folate sources at each meal. Try adding spinach to a morning omelet, having oranges or strawberries as a snack, and serving lentils or beans with dinner. Small changes can make a significant impact on folate intake.
Top folate-rich foods:
- Spinach
- Beef liver
- Black-eyed peas
- Asparagus
- Brussels sprouts
Supplements
Folate supplements can quickly raise folate levels if dietary changes are not enough.[31] Folic acid is the most common form of folate found in supplements, but some products contain methylfolate, which may be more effective for some people.[32]
Most adults need 400-800 micrograms of supplemental folate daily to correct a deficiency.[33] Your doctor can recommend the right dosage based on your blood tests. Taking supplements with food can help reduce the risk of side effects.
Folate supplements are generally considered safe; however, very high doses may mask a vitamin B12 deficiency.[34] It is important to follow a doctor’s advice when taking supplements. Some may experience minor digestive upset when first starting folate supplements.
Steps to choose and use folate supplements safely:
- Consult your doctor about the right dose
- Choose a reputable brand
- Take with food to improve absorption
- Be consistent with daily use
- Retest your levels after a few months
Prevention Strategies
Maintaining healthy folate levels is simpler than treating a deficiency.[35] A balanced diet, rich in vegetables and whole grains, establishes a solid foundation. Regular health check-ups can help identify low folate levels before symptoms occur.
Lifestyle choices affect folate levels. Limiting alcohol intake is important, as alcohol interferes with folate absorption.[36] Quitting smoking can also help improve folate levels, while regular exercise can help the body use folate more efficiently.[37]
Folate functions best when balanced with other B vitamins.[38] Eating a wide variety of foods helps ensure a full range of nutrients. If taking a B-complex supplement, choose one that contains balanced amounts of each vitamin.
Daily habits to prevent folate deficiency:
- Eat at least 5 servings of fruits and vegetables
- Choose whole grains over refined products
- Include beans or lentils in your meals
- Limit alcohol consumption
- Don’t overcook your vegetables
Folate and Other Health Conditions
Folate status affects more than just anemia risk; this vitamin also plays a role in many other bodily functions.[39] Research indicates that sufficient folate levels may also help prevent several chronic diseases.
Heart health benefits from proper folate intake. Folate helps regulate homocysteine, an amino acid linked to heart disease.[40] High homocysteine levels can damage blood vessels, while folate helps convert it into less harmful substances.
Some studies suggest that folate may reduce the risk of cancer, especially colorectal cancer.[41] Folate’s role in DNA synthesis and repair may explain this benefit; however, more research is needed to confirm these findings.
Folate can interact with some medications and may change how your body processes certain drugs.[42] It’s crucial to inform your doctor about all supplements being taken so they can check for any potential interactions with your prescribed medications.
| Health Condition | Potential Folate Impact |
|---|---|
| Heart Disease | May lower homocysteine levels |
| Colorectal Cancer | Possible reduced risk |
| Depression | May improve response to antidepressants |
| Birth Defects | Prevents neural tube defects |
Myths and Misconceptions
Misunderstandings surrounding folate and folic acid are common, so it’s important to clear up a few myths. Folate and folic acid are not identical; rather they are different forms of vitamin B9 that the body processes in different ways.[43]
People often confuse folate deficiency with other B vitamin deficiencies.[44] While these deficiencies may share similar symptoms, the causes and treatment differ. A proper diagnosis is key to effective treatment.
Some people worry about the safety of folate supplements; however, they are generally well tolerated when taken as directed.[45] While high doses can cause side effects, this is rare with typical supplementation.
Common myths about folate debunked:
- Myth: Folate and folic acid are identical
- Myth: All B vitamin deficiencies have the same causes
- Myth: Folate supplements are dangerous
- Myth: Only pregnant women need to worry about folate
- Myth: You can’t get enough folate from food alone
Special Populations at Risk
Certain groups are at higher risk for folate deficiency, and understanding these risk factors can help prevent problems. Regular screening may be needed for high-risk individuals.
Pregnant women need additional folate to support fetal development.[46] Without enough folate, the risk of birth defects rises. Women who are planning to become pregnant should start taking folate supplements before conception.
Older adults often have difficulty absorbing nutrients, including folate.[47] Medications common among this age group can also interfere with folate levels.[48] Regular check-ups can help detect deficiencies early.
People with digestive disorders may struggle to absorb folate from food.[49] Conditions like celiac disease and inflammatory bowel disease increase the risk of deficiency, and these individuals may need supplements to maintain healthy folate levels.
High-risk groups for folate deficiency:
- Pregnant women
- Older adults
- People with digestive disorders
- Heavy alcohol users
- Those on certain medications
Folate in the Modern Diet
Food processing can significantly affect folate content. Refining grains removes much of their natural folate, and overcooking vegetables destroys this delicate vitamin.[50] Understanding these effects can help you make better food choices.
Many countries now fortify certain foods with folic acid, a policy designed to reduce birth defects and improve public health. In the United States, enriched grains are required to contain added folic acid, which has helped to lower folate deficiency rates.[51]
Despite food fortification, meeting folate needs through diet alone can still be challenging.[52] Busy lifestyles and reliance on processed foods contribute to this problem. Awareness of folate-rich foods and proper cooking methods can help.
| Food | Folate Content (Raw) | Folate Content (Cooked) |
|---|---|---|
| Spinach (1 cup) | 58 mcg | 131 mcg (boiled) |
| Black Beans (1/2 cup) | 128 mcg | 128 mcg (canned) |
| Asparagus (4 spears) | 89 mcg | 89 mcg (boiled) |
| Avocado (1/2 fruit) | 81 mcg | N/A (eaten raw) |
FAQ
What foods are high in folate?
Can you take too much folic acid?
How long does it take to correct folate deficiency?
What happens if your folate is low?
Is folate the same as B12?
Do you need to take folate every day?
Folate, also known as vitamin B9, is a crucial cofactor in various metabolic reactions, including the synthesis of purines and pyrimidines, which are the building blocks of DNA and RNA.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Both folate and vitamin B12 are crucial for erythropoiesis, the process of red blood cell formation. Deficiencies in either can lead to megaloblastic anemia.
Source: “Perspective: The High-Folate–Low-Vitamin B-12 Interaction Is a Novel Cause of Vitamin B-12 Depletion with a Specific Etiology—A Hypothesis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803489/
Unlike some other nutrients, humans lack the enzymatic machinery to produce folate. Therefore, dietary intake or supplementation is necessary to meet folate requirements.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Folate is a generic term for various forms of vitamin B9, while folic acid is the synthetic, oxidized form used in supplements and food fortification. The body must convert folic acid into usable forms.
Source: “Association Between Maternal Folic Acid Supplementation and Congenital Heart Defects in Offspring in Birth Cohorts From Denmark and Norway” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6475034/
Folic acid is a more stable and bioavailable form of vitamin B9 than naturally occurring folates, which can be lost during food processing or cooking. It is readily absorbed in the small intestine
Source: “A bacterial route for folic acid supplementation” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6002978/
The Recommended Dietary Allowance (RDA) for folate in adults is 400 mcg Dietary Folate Equivalents (DFE). DFE accounts for the differences in bioavailability between food folates and folic acid.
Source: “Biological Properties of Vitamins of the B-Complex, Part 1: Vitamins B1, B2, B3, and B5” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839250/
The RDA for folate in pregnant women is 600 mcg DFE, which is higher than the requirement for non-pregnant women to support rapid cell division in the developing fetus.
Source: “Biological Properties of Vitamins of the B-Complex, Part 1: Vitamins B1, B2, B3, and B5” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839250/
The RDA for folate in lactating women is 500 mcg DFE to support the folate requirements of both the mother and the breastfeeding infant.
Source: “Biological Properties of Vitamins of the B-Complex, Part 1: Vitamins B1, B2, B3, and B5” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839250/
A diet low in folate rich foods, conditions that reduce nutrient absorbtion and medications that interfere with folate metabolism are all established causes of folate deficiency.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Processed foods often have lower folate content, and a diet lacking in fresh vegetables reduces dietary folate intake, increasing the risk of deficiency.
Source: “Biological Properties of Vitamins of the B-Complex, Part 1: Vitamins B1, B2, B3, and B5” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839250/
Folate is heat-sensitive, and prolonged cooking can degrade it. Alcohol can interfere with folate absorption, metabolism, and storage.
Source: “Scientific opinion on the tolerable upper intake level for folate” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641704/
Conditions like celiac and inflammatory bowel diseases impair the absorption of nutrients in the digestive tract. Dialysis can remove folate, increasing the risk of deficiency in patients on dialysis.
Source: “Vitamin and trace element deficiencies in the pediatric dialysis patient” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787050/
Methotrexate, used to treat conditions like cancer and rheumatoid arthritis, and some anti-seizure drugs are known to inhibit the activity of folate-dependent enzymes, leading to lower levels.
Source: “Evidence of Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874849/
Folate is essential for red blood cell formation and energy metabolism. In early stages, deficiency can lead to fatigue and general weakness.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Folate plays a role in neurological function, and deficiencies can affect the nervous system, leading to headaches, difficulty concentrating, and mood disturbances.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Chronic deficiency can cause megaloblastic anemia, a condition characterized by large, immature red blood cells that reduces oxygen delivery.
Source: “Perspective: The High-Folate–Low-Vitamin B-12 Interaction Is a Novel Cause of Vitamin B-12 Depletion with a Specific Etiology—A Hypothesis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803489/
Severe folate deficiency can result in damage to nerve fibers, which can manifest as numbness or tingling in the extremities.
Source: “Scientific opinion on the tolerable upper intake level for folate” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641704/
Severe folate deficiency can impair neurological function, leading to confusion, memory problems, and depressive symptoms.
Source: “Scientific opinion on the tolerable upper intake level for folate” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641704/
Folate is essential for cell growth and division, which are crucial during pregnancy for the development of the fetus.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Folate plays a critical role in closing the neural tube, the precursor to the brain and spinal cord during early pregnancy.
Source: “Review of Existing Models to Predict Reductions in Neural Tube Defects Due to Folic Acid Fortification and Model Results Using Data from Cameroon” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634386/
Sufficient folate intake, particularly during the periconceptional period, significantly reduces the risk of neural tube defects.
Source: “Review of Existing Models to Predict Reductions in Neural Tube Defects Due to Folic Acid Fortification and Model Results Using Data from Cameroon” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634386/
Neural tube defects (NTDs) are a type of birth defect caused by the incomplete closure of the neural tube during early embryonic development.
Source: “A quest for genetic causes underlying signaling pathways associated with neural tube defects” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241075/
Adequate periconceptional folate intake has been shown to reduce the occurrence of neural tube defects by 50-70%.
Source: “Review of Existing Models to Predict Reductions in Neural Tube Defects Due to Folic Acid Fortification and Model Results Using Data from Cameroon” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634386/
This intake is needed to support the rapid growth and cell division of the fetus and to lower the risk of birth defects, including neural tube defects.
Source: “Biological Properties of Vitamins of the B-Complex, Part 1: Vitamins B1, B2, B3, and B5” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839250/
Serum folate tests measure the amount of folate in the blood and erythrocyte folate measures folate levels in red blood cells.
Source: “Perspective: The High-Folate–Low-Vitamin B-12 Interaction Is a Novel Cause of Vitamin B-12 Depletion with a Specific Etiology—A Hypothesis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803489/
Serum folate levels reflect recent folate intake, while red blood cell folate levels reflect long term folate status.
Source: “Perspective: The High-Folate–Low-Vitamin B-12 Interaction Is a Novel Cause of Vitamin B-12 Depletion with a Specific Etiology—A Hypothesis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803489/
The generally accepted cutoff for normal serum folate levels is > 3 ng/mL. Levels < 2 ng/mL are considered deficient, however, some labs use slightly different reference ranges.
Source: “Perspective: The High-Folate–Low-Vitamin B-12 Interaction Is a Novel Cause of Vitamin B-12 Depletion with a Specific Etiology—A Hypothesis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803489/
Red blood cell folate levels reflect the folate status of red blood cells during their formation. Typically, levels above 140 ng/mL are considered adequate. Levels below indicate a chronic deficiency.
Source: “Perspective: The High-Folate–Low-Vitamin B-12 Interaction Is a Novel Cause of Vitamin B-12 Depletion with a Specific Etiology—A Hypothesis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803489/
Increasing the consumption of folate rich foods can improve folate status in individuals with mild folate deficiency.
Source: “Biological Properties of Vitamins of the B-Complex, Part 1: Vitamins B1, B2, B3, and B5” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839250/
These foods contain high amounts of folate and are also a good source of other vitamins, minerals, and fiber.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Folate supplementation can rapidly improve folate status in individuals who are unable to get sufficient folate from food.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
While folic acid is common in supplements, methylfolate (5-MTHF) is an active form of folate that may be better for some individuals, especially those who have a genetic polymorphism that affects the folic acid metabolism.
Source: “Association Between Maternal Folic Acid Supplementation and Congenital Heart Defects in Offspring in Birth Cohorts From Denmark and Norway” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6475034/
Dosage can vary, but a common dose for supplementation is in the 400-800 mcg range. A healthcare provider can make a specific recommendation.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
High dose folic acid supplementation can correct anemia caused by B12 deficiency, masking the deficiency while underlying neurological damage continues. This effect is particularly important for older adults.
Source: “Perspective: The High-Folate–Low-Vitamin B-12 Interaction Is a Novel Cause of Vitamin B-12 Depletion with a Specific Etiology—A Hypothesis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803489/
Consuming a balanced diet rich in folate is preferable to addressing a deficiency after it has developed.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Excessive alcohol intake is known to interfere with the absorption and metabolism of folate, contributing to deficiency.
Source: “Scientific opinion on the tolerable upper intake level for folate” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641704/
Smoking reduces nutrient absorbtion and excersize can help to improve overall bodily function. While smoking does affect folate levels, there is limited direct evidence that it ‘improves folate levels’. Similarly, exercise is known to improve overall health, the specific link with better folate utilization has not been fully studied.
Source: “Wheat flour fortification with iron and other micronutrients for reducing anaemia and improving iron status in populations” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8407500/
The B vitamins are a group of water-soluble vitamins that work synergistically in many metabolic pathways. A diet rich in a variety of foods will provide balanced amounts of B vitamins.
Source: “Vitamin B Complex Treatment Attenuates Local Inflammation after Peripheral Nerve Injury” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6943485/
Folate is involved in DNA synthesis, cell division, and neurotransmitter synthesis and, therefore, has a broad impact on overall health.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Folate is required for the metabolism of homocysteine. Elevated homocysteine levels are associated with an increased risk of heart disease.
Source: “A Randomized Pilot Trial to Evaluate the Bioavailability of Natural versus Synthetic Vitamin B Complexes in Healthy Humans and Their Effects on Homocysteine, Oxidative Stress, and Antioxidant Levels” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6930747/
Some studies have linked higher folate intake with reduced risk of certain cancers, but the research is still ongoing. The results are not consistent, and more research is required to confirm these findings.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Folate can interact with medications including methotrexate and certain anti-seizure medications. It can also affect the metabolism of other drugs.
Source: “Evidence of Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874849/
Folate refers to naturally occurring forms of vitamin B9, and folic acid is a synthetic form. They have different chemical structures and are processed differently in the body.
Source: “Association Between Maternal Folic Acid Supplementation and Congenital Heart Defects in Offspring in Birth Cohorts From Denmark and Norway” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6475034/
The symptoms of B vitamin deficiencies can often overlap. It is important to get the proper testing done.
Source: “Vitamin B Complex Treatment Attenuates Local Inflammation after Peripheral Nerve Injury” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6943485/
Folate supplements are generally safe and well tolerated, particularly when taken in the recommended doses. Extremely high doses can lead to side effects.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Pregnant women require more folate than non-pregnant women to support the rapid cell growth and development of the fetus.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Older adults may experience reduced nutrient absorption due to age-related changes in the digestive system.
Source: “Gut Microbiome–Brain Alliance: A Landscape View into Mental and Gastrointestinal Health and Disorders” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10197139/
Many common medications used by older adults can interfere with folate absorption or metabolism, increasing deficiency risk.
Source: “Evidence of Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874849/
Conditions like celiac disease and inflammatory bowel disease can damage the intestinal lining, leading to impaired folate absorption.
Source: “Scientific opinion on the tolerable upper intake level for folate” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641704/
Food processing such as refining grains and cooking can reduce the folate levels.
Source: “Scientific opinion on the tolerable upper intake level for folate” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641704/
The mandatory folic acid fortification of grains in the United States has resulted in significant decreases in neural tube defect rates and improved folate status in the population.
Source: “Folic Acid and the Prevention of Birth Defects: 30 Years of Opportunity and Controversies” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9875360/
Despite mandatory fortification, it can be difficult for some to meet their folate requirements through diet alone, particularly when processed foods dominate.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Foods such as dark green leafy vegetables (spinach), legumes (black-eyed peas) and beef liver are rich in folate. Citrus fruits and fortified grains also contribute to dietary folate intake.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
While generally safe, high-dose folic acid supplementation can have side effects, and following a healthcare provider’s recommendations is best.
Source: “Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648405/
Folate levels can improve quickly with adequate supplementation, but it may take several months to fully resolve the deficiency and associated symptoms.
Source: “Perspective: The High-Folate–Low-Vitamin B-12 Interaction Is a Novel Cause of Vitamin B-12 Depletion with a Specific Etiology—A Hypothesis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803489/
Folate deficiency is associated with fatigue, weakness and anemia. Severe deficiency may lead to neurological problems, and in pregnant women it raises the risk of neural tube defects.
Source: “Scientific opinion on the tolerable upper intake level for folate” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641704/
