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Folate deficiency

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 2 minutes read

Folate is a water-soluble vitamin that makes and repairs DNA and red blood cells. Folate is not stored in fat cells, so levels can easily deplete if not maintained. Reduction of folate can occur predominantly with dietary deficiencies. It can also happen due to disease or as a side effect of medication. Folate is important for women of childbearing age as deficiencies can lead to birth defects. Therefore, supplements are always recommended for pregnant women. Folate deficiency can lead to anemia, reducing the amount of oxygen available for your tissues and cells. 

What are the symptoms of folate deficiency?

Folate deficiency on its own can lead to subtle symptoms like tiredness, irritability, mouth ulcers, swelling of the tongue, or graying of the hair.

As folate deficiency can lead to anemia, the symptoms of anemia include tiredness, weakness, shortness of breath, chest pain, pale skin, and dizziness.

What causes folate deficiency?

Folate deficiency can be caused by diet. Folate is added to cereals, citrus juices, leafy green vegetables, broccoli, and brussels sprouts. Lack of these foods in the diet or overcooking them can destroy necessary vitamins and reduce their availability. Alcohol has a similar effect.

Certain diseases that affect bowel absorption can affect the ability of folate to be properly absorbed. Examples include celiac disease, Crohn's disease, and bowel cancers. Genetic diseases involving the MTHFR gene can affect the body's ability to convert folate into an active form in the body.

Medications such as trimethoprim (used for urinary tract infections), methotrexate and sulfasalazine (used in joint, skin, and autoimmune conditions), and phenytoin (seizure medication) can all cause folate deficiency.

Treatment of folate deficiency

An important step for treating and preventing folate deficiency is to increase the dietary intake of folate sources. Foods high in folate include legumes, lentils, eggs, leafy green vegetables, citrus fruits, brussel sprouts, broccoli, nuts, and seeds.

Folic acid supplements can be prescribed if your doctor thinks you need extra help correcting your levels. If you have folate deficiency, it is advised to avoid alcohol. Pregnant women are advised to take folic acid supplements at 400 micrograms daily and avoid alcohol intake.

What are the complications of folate deficiency?

Folate deficiency is quite easily treatable. If untreated for some time, there is an increased risk of certain cancers and heart disease. When pregnant, it poses the greatest risk to the unborn child, causing birth defects, but it can also make it difficult to get pregnant.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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