What Should I Take if Folic Acid is Low?: Your Guide to Addressing a Deficiency

October 17, 2025 •

4 min read

According to the Centers for Disease Control and Prevention (CDC), getting enough folic acid is crucial for preventing certain serious birth defects, making it a key focus for women of childbearing age. If tests show your folic acid is low, a combination of dietary adjustments and supplementation is often the recommended path to recovery.

Quick Summary

Address a folic acid deficiency with dietary changes, including folate-rich and fortified foods, and supplementation under a doctor's guidance. The treatment plan varies based on the deficiency's severity and underlying causes.

Key Points

Consult a Doctor: Always seek medical advice for a proper diagnosis and treatment plan, as the cause of low folic acid needs to be identified.
Start Supplements: For deficiencies, a doctor will likely prescribe daily folic acid tablets, which are the most effective way to restore levels.
Boost Your Diet: Increase your intake of folate-rich foods such as leafy greens, legumes, and citrus fruits to support long-term levels.
Prioritize Fortified Foods: Incorporate enriched grains like cereals and bread to increase your overall folic acid intake, particularly if natural intake is inconsistent.
Consider MTHFR Mutation: If you have this genetic variant, a doctor may recommend supplements with L-methylfolate, the active form, instead of standard folic acid.
Watch for B12 Levels: High intake of folic acid can mask a vitamin B12 deficiency, so a doctor may check both levels to prevent nerve damage.
Manage Underlying Issues: Treat any medical conditions, like celiac disease or excessive alcohol use, that may be affecting your body's ability to absorb folate.

Understanding Low Folic Acid: Why It Happens

Low folic acid, also known as folate deficiency, occurs when your body doesn't get enough of this essential B vitamin. Folate is crucial for producing and maintaining new cells, which is why a deficiency can lead to various health problems, most notably megaloblastic anemia. Causes range from poor diet to medical conditions that interfere with absorption.

Common Causes of Folate Deficiency

Inadequate Diet: This is the most common cause. Not eating enough folate-rich foods, like leafy greens, legumes, and certain fruits, can lead to low levels.
Increased Demand: Pregnancy and breastfeeding significantly increase the body's need for folate to support rapid cell growth. Insufficient intake during this time is a major concern.
Malabsorption Issues: Conditions affecting the digestive tract, such as celiac disease or Crohn's disease, can hinder the absorption of nutrients, including folate.
Excessive Alcohol Use: Chronic, excessive alcohol consumption can interfere with the absorption of folate.
Certain Medications: Some drugs, including those for seizures and specific types of cancer treatment, can interfere with folate metabolism.
Genetics: Some individuals have a genetic mutation, such as MTHFR, that affects their body's ability to convert folic acid into its active form, 5-MTHF.

What Should I Take if Folic Acid is Low?: Treatment Options

Addressing a folic acid deficiency typically involves a two-pronged approach: supplementation and diet. Your healthcare provider will determine the right course of action based on the severity of your deficiency and any underlying issues.

Folic Acid Supplements

For moderate to severe deficiencies, or for pregnant women, supplementation is the fastest and most effective way to restore folate levels.

Oral Tablets: The most common form of treatment is a daily folic acid tablet. A healthcare provider will prescribe the appropriate amount and duration of treatment to replenish the body's stores.
Higher Potency Options: In certain scenarios, such as a previous pregnancy affected by a neural tube defect or specific medical conditions, a doctor may recommend higher potency supplementation.
Active Folate (L-Methylfolate): For individuals with the MTHFR gene mutation, taking L-methylfolate—the active form of folate—may be more effective as it bypasses the need for the MTHFR enzyme.

Incorporating Folate-Rich Foods

In addition to supplements, a balanced diet is essential for maintaining long-term folate levels. Folate from food is called "folate," while the synthetic version in supplements and fortified foods is "folic acid".

Natural Sources of Folate

Dark Leafy Greens: Spinach, kale, and romaine lettuce are excellent sources.
Legumes: Lentils, chickpeas, peas, and kidney beans are packed with folate.
Fruits: Citrus fruits (oranges), avocado, bananas, and papaya are rich in folate.
Other Vegetables: Asparagus, broccoli, and beets are also good sources.
Animal Products: Beef liver is a potent source of folate, though pregnant women should avoid it due to high vitamin A content.

Fortified Foods (Contain Folic Acid)

Enriched Grains: Breads, pasta, rice, and cereals are often fortified with folic acid to help prevent deficiencies. Look for the term "enriched" on the ingredient list.

Natural Folate vs. Synthetic Folic Acid: A Comparison

While both natural folate and synthetic folic acid help address a deficiency, they differ in how the body processes and utilizes them.


Feature	Natural Folate	Synthetic Folic Acid
Source	Found naturally in foods like leafy greens, fruits, and legumes.	Man-made form found in supplements and fortified foods.
Absorption	Processed in the small intestine and converted to the active form.	Metabolized by the liver and other tissues, potentially slower to act.
Stability	Easily broken down by heat and light during cooking.	Much more stable and less susceptible to degradation from heat.
Metabolism	Converted to its active form (5-MTHF) in the intestines.	Requires conversion via the MTHFR enzyme; some individuals have a mutation affecting this.
Overconsumption Risk	Generally not associated with side effects from overconsumption from food sources.	High intake can potentially mask an underlying vitamin B12 deficiency.

How to Manage Your Deficiency: A Step-by-Step Approach

Consult a Healthcare Provider: Always start by getting a proper diagnosis and discussing a treatment plan with a doctor. They can rule out other conditions and determine the cause of your low levels.
Take Your Prescribed Supplements: Follow your doctor's instructions for daily intake and duration. For pregnant women, a specific regimen is critical.
Boost Your Diet: Incorporate a wide variety of folate-rich foods into your daily meals. Focus on raw or lightly cooked vegetables to maximize folate retention.
Consider Fortified Foods: Read labels and choose enriched products like cereals and breads to supplement your natural folate intake.
Address Underlying Conditions: If your deficiency is caused by a medical issue like celiac disease, work with your healthcare provider to manage that condition as well.
Manage Alcohol Intake: If excessive alcohol use is a factor, reducing or eliminating it is important for improving folate absorption.

Conclusion: Rebalancing Your Folic Acid Levels

Learning what should I take if folic acid is low is the first step toward correcting a deficiency. While supplements are the most direct treatment for restoring levels, a balanced diet rich in natural folate is key for long-term health and maintenance. Working with a healthcare provider to create a personalized plan, especially for pregnant women or those with genetic predispositions like the MTHFR mutation, ensures the most effective and safest approach. By combining targeted supplementation with informed dietary choices, you can effectively manage low folic acid and prevent associated health complications, such as megaloblastic anemia and birth defects. The ultimate goal is not just to treat the deficiency but to cultivate sustainable nutritional habits for lifelong well-being. For more information, the Centers for Disease Control and Prevention offers a wealth of resources on the importance and sources of folic acid.

Frequently Asked Questions

Folate is the naturally occurring form of vitamin B9 found in foods like vegetables and legumes. Folic acid is the synthetic, man-made version found in supplements and fortified foods, and it is more stable than natural folate.

Folic acid supplements can restore your levels over a period of time, depending on the severity of the deficiency. A healthcare provider will prescribe a daily approach and duration, which is often for several months.

While a balanced diet is crucial, it can be difficult for some people, especially pregnant women, to get enough folate from food alone. Many foods lose folate during cooking, and supplements or fortified foods ensure a consistent intake.

Some of the best natural sources include dark leafy greens (spinach, kale), legumes (lentils, chickpeas), citrus fruits (oranges), avocado, asparagus, and fortified grains and cereals.

You cannot get too much natural folate from food. However, taking high amounts of synthetic folic acid through supplements can mask a vitamin B12 deficiency, potentially leading to neurological issues if left untreated. High intake should be medically supervised.

Folic acid is vital during the early stages of pregnancy to help prevent serious birth defects of the baby's brain and spine, known as neural tube defects. A supplement is recommended for women who are trying to conceive and through the first trimester.

Yes, symptoms of a folic acid deficiency can develop gradually and be subtle, often mimicking other conditions. Early signs can include fatigue, irritability, and shortness of breath.