Can Folate Deficiency Cause Shakiness? Understanding the Connection

October 10, 2025 •

4 min read

Some studies suggest a link between folate deficiency and neurological issues that may include shakiness or tremors, especially in specific conditions. However, it is a complex relationship that is often intertwined with other factors, particularly a vitamin B12 deficiency.

Quick Summary

While not a common primary cause, a severe folate deficiency or specific disorders can lead to neurological symptoms like shakiness or tremors, often in connection with megaloblastic anemia or cerebral folate deficiency. A B12 deficiency is a much more frequent cause of such neurological issues.

Key Points

Rare but Possible Connection: While isolated folate deficiency is not a typical cause of shakiness, a severe deficiency or specific conditions like Cerebral Folate Deficiency can lead to tremors.
B12 Deficiency is More Common: Shakiness is a much more characteristic symptom of a vitamin B12 deficiency, which is often intertwined with folate status.
Synergistic Relationship: Folate and B12 deficiencies are interconnected, and addressing one without the other can be problematic, especially for neurological symptoms.
Impact on Nerves: Folate is essential for nerve function, DNA repair, and creating the protective myelin sheath, so a lack can disrupt neurological processes.
Medical Diagnosis is Key: Given multiple potential causes, it is crucial to consult a healthcare professional to properly diagnose the source of any unexplained shakiness.

Is Folate Deficiency Linked to Shakiness?

While mild folate deficiency typically causes symptoms like fatigue and anemia, severe cases, especially when affecting the brain, can result in neurological manifestations that include shakiness or tremors. This connection is particularly evident in rare genetic conditions like cerebral folate transport deficiency, where motor issues can be severe. In other cases, tremors have been observed in infants with megaloblastic anemia caused by folate deficiency. However, it is critical to understand that shakiness is a more characteristic symptom of a vitamin B12 deficiency, and the two are closely linked.

Folate's Essential Role in Neurological Function

Folate (vitamin B9) is a water-soluble vitamin essential for many bodily functions. Its role is particularly crucial for the nervous system:

DNA and RNA Synthesis: Folate is necessary for creating DNA and RNA, which is vital for cell growth, particularly in the rapidly developing nervous system.
Myelination: It is involved in the synthesis of myelin, the protective fatty sheath that insulates nerve fibers and ensures proper transmission of nerve impulses. Without proper myelination, nerve signals can be disrupted, leading to neurological symptoms.
Neurotransmitter Production: Folate is involved in the creation of several important neurotransmitters that regulate brain function. A deficiency can alter these chemical messengers, contributing to neuropsychiatric issues like depression and confusion.

The Complex Relationship with Vitamin B12

Folate and vitamin B12 work together closely in metabolic processes. A deficiency in one can impact the other, and a crucial clinical point is that treating folate deficiency alone in the presence of an undiagnosed B12 deficiency can exacerbate severe neurological complications. This happens because high-dose folate can mask the hematological signs (anemia) of a B12 deficiency while allowing the nerve damage to progress unchecked. Therefore, doctors will always check both vitamin levels when investigating unexplained neurological symptoms.

Comparison: Folate Deficiency vs. B12 Deficiency


Feature	Folate Deficiency	Vitamin B12 Deficiency
Common Symptoms	Fatigue, weakness, mouth sores, pale skin, diarrhea.	Fatigue, memory loss, sore tongue, pins and needles, numbness, muscle weakness.
Neurological Symptoms	Possible, especially in severe or specific conditions; may involve confusion or depression.	More common and characteristic; often includes tingling, numbness, and balance issues.
Shakiness/Tremors	Possible but rare, often linked to cerebral forms or megaloblastic anemia in infants.	A more frequently associated neurological symptom.
Symptom Onset	Symptoms can develop relatively quickly, within weeks.	Symptoms typically develop slowly over months to years.
Absorption Issues	Common causes include celiac disease, Crohn's disease, and excessive alcohol use.	Often caused by pernicious anemia, gastric surgeries, or strict vegetarian/vegan diets.
Treatment Consideration	Supplementation can worsen B12-related nerve damage if B12 is also deficient.	Replenishing B12 is essential for addressing neurological symptoms.

Other Potential Causes of Shakiness

If you are experiencing shakiness, it is important to consider that a nutritional deficiency may not be the primary cause. A doctor will evaluate a number of possibilities, including:

Essential Tremor: A common neurological disorder that causes involuntary, rhythmic shaking, most often in the hands.
Parkinson's Disease: This neurodegenerative disorder can cause tremors, especially resting tremors.
Overactive Thyroid (Hyperthyroidism): An overactive thyroid gland can cause tremors and weakness.
Anxiety and Stress: High anxiety or stress levels can trigger or worsen a physiologic tremor that is normally unnoticeable.
Caffeine Overload: Excessive consumption of caffeine can overstimulate the nervous system, causing jitters and shakiness.
Medications: Certain prescription drugs, such as those for asthma, psychiatric conditions, or some cancer treatments, can cause tremors as a side effect.
Alcohol Withdrawal: Shakiness is a well-known symptom of alcohol withdrawal.

What to Do If You Experience Shakiness

If you have persistent or unexplained shakiness, it is important to seek medical advice. Here is a guide on how to approach the issue:

Consult a Healthcare Provider: Schedule an appointment with a doctor. Be prepared to discuss your symptoms, medical history, diet, and any medications you are taking.
Request Blood Work: Ask your doctor to check your folate and vitamin B12 levels. A simple blood test can reveal a nutritional deficiency.
Review Medications: Discuss all your medications with your doctor, as some may contribute to tremors.
Consider Diet: Examine your diet. Are you consuming enough folate-rich foods like leafy greens, citrus fruits, and legumes?.
Avoid Triggers: Reduce or eliminate caffeine and alcohol, as these can exacerbate tremors.

Conclusion

While the direct link between isolated folate deficiency and shakiness is not as common as the link to vitamin B12, it is a scientifically recognized symptom in certain severe or congenital conditions. The complex interplay between folate and B12 necessitates testing for both deficiencies when neurological symptoms are present. Shakiness has many potential causes, and only a medical professional can provide an accurate diagnosis. By understanding the role of folate in nerve health and considering all possible factors, you can take the right steps toward finding the root cause and effective treatment.

For more information on cerebral folate deficiency, you can consult the National Organization for Rare Disorders (NORD) at https://rarediseases.org/rare-diseases/cerebral-folate-deficiency/.

Frequently Asked Questions

Yes, in rare cases or specific conditions like cerebral folate deficiency, a lack of folic acid (folate) has been linked to tremors and other motor issues. It is not a typical symptom of standard folate deficiency, which more commonly causes fatigue and weakness.

Folate and B12 work together closely. Vitamin B12 deficiency is a much more common cause of neurological symptoms like shakiness, tingling, and numbness. Supplementing folate without addressing a concurrent B12 deficiency can worsen nerve problems.

Other common symptoms of folate deficiency include extreme tiredness, fatigue, pale skin, a sore or tender tongue, and mouth ulcers. These are often associated with the anemia that results from the deficiency.

A blood test can measure your folate and vitamin B12 levels, providing critical information to help a doctor determine if a nutritional deficiency is a possible cause of your symptoms. However, further neurological evaluation may be necessary.

This is a rare disorder where there is a shortage of folate in the brain, often due to a genetic mutation or autoimmune issue. This can lead to severe neurological problems, including tremors, ataxia (poor coordination), and cognitive delays.

Many other factors can cause shakiness or tremors, including essential tremor, Parkinson's disease, hyperthyroidism (overactive thyroid), anxiety, high caffeine intake, and certain medications.

Treatment for folate deficiency involves taking folic acid supplements and increasing your dietary intake of folate-rich foods like leafy greens, citrus fruits, legumes, and fortified grains.

If properly diagnosed and treated, neurological symptoms from a folate deficiency are often reversible, especially when caught early. However, treatment must address any underlying B12 deficiency to prevent permanent nerve damage.