Folate deficiency: Causes, Risk Factors, Symptoms, Treatment

Folate deficiency

The word of folic acid is derived from Latin word folium means leaf and it is also isolated leafy vegetable spinach. The most stable form of folate is folic acid, which is rarely found in food. Vitamin B9 also called as folate or folic acid is one of B Vitamins. All B vitamins help the body convert food into fuel , which is used to produce energy. Folic acid is the synthetic form of B9, found in supplements and fortified foods, while folate occurs naturally in foods. Folic acid is water soluble vitamin, folic acid itself not biologically active but it’s biological importance is due to Tetrahydrofolate and other derivatives. Tetrahydrofolate( THF or FH 4 ) is the active form of folic acid. TH4 participates in DNA synthesis as well as cell division. TH4 is involved in the synthesis of the amino acid glycine, which in turn is required for heme synthesis and thus hemoglobin synthesis. TH4 also participates in the reduction of blood homocysteine concentration and indirectly in gene [removed]with the enzyme methionine synthase). Blood homocysteine concentration are high in patients with cardiovascular disease. Nonetheless, adequate dietary folate is one of the important factors for the prevention of hyperhomocysteinemia. Folate is particularly important to help develop the baby’s skull and spinal cord, which is why low levels of this vitamin, before and during pregnancy, can lead to severe birth defects, called neural tube defects.

Symptoms of Folate deficiency

If you suspect you or someone else is experiencing Folate deficiency, it is crucial to seek immediate medical attention by calling emergency services or consult with a Nutritionist.


The most common causes of Folate deficiency is not having a healthy lifestyle and not eating a healthy, balanced diet. A healthy diet includes foods naturally contain folate or folic acid. People who drink large amount of alcohol , they don’t get enough folate requirement to the body. Other causes of folate deficiency can include many diseases like, Digestive system diseases: when there is a Crohn’s disease or celiac disease, the digestive system doesn’t absorb folic acid properly. Hemolytic anemia: It is one of the blood disorder that is occurred when your red blood cells are destroyed and can’t be replaced fast enough. When you over cook the vegetables and fruits, the heat can destroy the naturally occurring folate in your produce. It is easily leaches into cooking water, especially when the food is submerged in the water. As much as 50% to 90% of food folate may be destroyed during food processing, storage and preparation.

Risk Factors

The common risk factors of folate deficiency include: • Eating overcooked foods • Consuming a vitamin poor diet • Heavy alcohol abuse • Pregnancy • Being of childbearing age • Malabsorption syndromes such as celiac disease and inflammatory bowel disesae • Certain medications • Medical conditions, such as sickle cell disease In pregnancy , the risk factors include spina bifida and anencephaly Spina bifida: it is a condition that occurs when a baby’s spinal cord or brain don’t fully develop in the womb. Babies born with spina bifida requires surgery, and often have paralysis and other physical disabilities Anencephaly: it is a condition where baby’s brain and skull don’t develop completely in womb. In this condition baby’s are stillborn or die shortly after birth.


Folate deficiency also affects the intestinal epithelium, where impaired DNA synthesis causes megaloblastosis of enterocytes. Folate deficiency impairs DNA and RNA synthesis. Thus, rapidly dividing cells are affected quickly by folate deficiency. When red blood cells cannot divide, the result is large and immature erthrocytes(i.e., megaloblastic macrocytic anemia) This is manifested clinically as malabsorption and diarrhea and is a contributor to the clinical picture of tropical sprue. Severely anemic individuals show weakness, fatigue, difficulty in concentrating, irritability, headache, palpitations and shortness of breath. Nuclear hypersegmentation of circulating polymorphonuclear leucocytes appears within about two months of deprivation of the Vitamin. This is followed by megaloblastic anemia, and then general weakness, depression and polyneuropathy. In pregnant women, the deficiency can lead to birth defects or spontaneous abortion and also Neural Tube Defects( NTD). Neural tube defects such as spina bifida and anencephaly are some of the most common birt defects in United States , they affect approximately 1 in every 1000 pregnancies . In general Weakness, nausea, loss of appetite, lethargy, shortness of breath, fatigue, glossitis, megaloblastic anemia, mouth sores, gray hair, swollen tongue.

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Medical history and Symptoms present in the body can be diagnosed. The folate deficiency can be diagnosed through a blood test. It measures the amount of folate in blood. A low level of folate indicates a folate deficiency.


A balanced diet includes fruits and vegetables and other foods that contain folate or are enriched with folic acid can be included in daily diet. The folate deficiency can be treated with folic acid supplements. Most of the adults need 400mcg of folic acid in each day. During pregnancy, the RDA is increased to 600mcg/day to meet the elevated needs for fetal growth. A lactating mother needs 500mcg/ day. For infants, 65mcg/day during first 6 months and 80mcg/day from the ages of 7 to 12 months.

Preventive Measures

The best way to prevent the folate deficiency is to eat healthy. The diet that includes fruits and vegetables which contains folate or folic acid. The food that contain folate or folic acid are Green leafy vegetables, orange juice, dried beans, peas, legumes, chicken liver, sea food, eggs and dairy. The folic acid can be found in enriched or fortified in bread , flour, pasta, rice, cereal..

Do's & Don’t's

Do's Don't
Consume folate-rich foods such as leafy green vegetables, legumes, citrus fruits, and fortified grains. Avoid excessive alcohol consumption as it can interfere with folate absorption.
Take folate supplements as prescribed by a healthcare professional. Don't rely solely on supplements without considering dietary sources of folate.
Follow a balanced diet with a variety of nutrients to support overall health. Don't consume raw eggs as they contain a protein that can interfere with folate absorption.
Cook foods at low temperatures to preserve folate content. Avoid overcooking or prolonged heating of folate-rich foods, which can reduce their folate content.
Discuss medication interactions with a healthcare provider as certain medications can interfere with folate absorption. Don't self-diagnose folate deficiency; seek medical advice for proper diagnosis and treatment.
Monitor and manage any underlying health conditions that may contribute to folate deficiency. Don't ignore symptoms of folate deficiency such as weakness, fatigue, or cognitive issues; consult a healthcare professional.

If you suspect you or someone else is experiencing Folate deficiency, it is crucial to seek immediate medical attention by calling emergency services or consult with a Nutritionist.

Frequently Asked Questions
Folate, also known as vitamin B9, is a water-soluble vitamin that is essential for various bodily functions, including DNA synthesis, red blood cell formation, and proper neural tube development during pregnancy.
Folate deficiency can result from insufficient dietary intake, poor absorption in the digestive tract, certain medications, alcoholism, and increased demand during pregnancy or certain medical conditions.
Common symptoms include fatigue, weakness, shortness of breath, pale skin, irritability, and difficulty concentrating. In pregnant women, folate deficiency can lead to neural tube defects in the developing fetus.
Blood tests, specifically measuring serum folate levels, can help diagnose folate deficiency. Additionally, red blood cell folate levels may provide a more accurate assessment of long-term folate status.
Folate is found in a variety of foods, including leafy green vegetables (spinach, kale), legumes (lentils, chickpeas), fruits (oranges, bananas), and fortified cereals. Liver and some animal products also contain folate.
Yes, folate deficiency can often be prevented by maintaining a balanced diet rich in folate-containing foods. Additionally, folic acid supplements are recommended for pregnant women and those at risk of deficiency.
Treatment typically involves increasing dietary intake of folate through food sources or taking folic acid supplements. The underlying cause of the deficiency, if identified, should also be addressed.
Risk factors include inadequate dietary intake, certain medical conditions (such as celiac disease and inflammatory bowel disease), alcoholism, and certain medications (like methotrexate and some anticonvulsants).
Yes, folate deficiency during pregnancy is associated with an increased risk of neural tube defects in the developing fetus. Adequate folate intake before and during early pregnancy is crucial for preventing such birth defects.
Untreated folate deficiency can lead to megaloblastic anemia, neural tube defects in newborns, and other neurological complications. It may also contribute to other health issues over time.
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