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Folate is an essential nutrient. A lack of dietary folate can cause anemia, which is especially dangerous for women during pregnancy. Folate is necessary for creating red blood cells, which carry oxygen to the body’s tissues.
A lack of folate leads to anemia, a condition in which the body cannot create a sufficient number of red blood cells. Folate deficiency anemia is one of many different types of anemia.
If a person does not have enough red blood cells, their organs and tissues do not get enough oxygen, and their body cannot function efficiently.
As a result, they may experience classic anemia symptoms, such as fatigue, muscle weakness, and pale skin.
Getting enough folate through the diet and supplements is the best way to prevent folate deficiency anemia. The synthetic form of folate is called folic acid. Folic acid is present in many prenatal vitamins, multivitamins, and B complex vitamins, and it is also available as a separate vitamin supplement.
Folate deficiency may occur if a person does not consume enough foods that contain folate. However, even people who eat a healthful, balanced diet can develop folate deficiency.
The causes of folate deficiency anemia include:
not eating enough folate-rich foods
having a disease or condition that interferes with vitamin absorption, such as celiac disease or inflammatory bowel disease (IBD)
having alcohol use disorder, as alcohol interferes with folate absorption and causes the body to remove folate too quickly
being pregnant, which increases the body’s demand for folate
taking a medication that interferes with folate absorption or lowers folate levels
having a methylenetetrahydrofolate reductase (MTHFR) gene variant, as this interferes with the body’s ability both to convert folate to its active form in the body and to use it
Like all vitamin Bs, folate dissolves in water, and this means that the body cannot store it. The kidneys excrete any excess folate in the urine.
As a result, people can become deficient in folate within just a few weeks if their diet does not include enough folate or if they have a health condition that interferes with its absorption.
Everyone needs to get the recommended amount of folate each day because the body cannot store it. It is especially important for women who are pregnant or who could become pregnant.
Major health organizations, including the Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists, recommend that women of childbearing age take a folic acid supplement every day. They offer this advice because low levels of folate increase the risk of having a baby with serious congenital disabilities of the brain and spinal cord.
At first, a person may not have obvious symptoms of folate deficiency anemia, but as it becomes more severe, people may notice:
weakness
feeling lightheaded
fatigue
trouble concentrating
irritability
headaches
a sore tongue
sores in the mouth or on the tongue
in pregnant women, having a baby with specific neural tube defects.
Risk factors for folate deficiency include:
- malnutrition or not eating a varied diet that includes fruits, vegetables, and fortified foods
- having alcohol use disorder or drinking large amounts of alcohol regularly
- being a woman of childbearing age
- being pregnant
- having a malabsorptive disorder
- having the MTHFR polymorphism gene variation that interferes with how the body uses folate
- taking certain medications, including methotrexate, antiseizure medicines, and some medicines that treat ulcerative colitis