The Role of Folate in Your Body
Folate, also known as vitamin B9, is a water-soluble vitamin essential for numerous bodily functions. It is critical for the formation of red blood cells, which carry oxygen throughout the body. Folate also plays a vital role in DNA synthesis, cell growth, and the repair of tissues and nerve cells. The synthetic form, folic acid, is commonly added to fortified foods like cereals and bread, and is available in supplements. Because the body cannot store large amounts of folate, a consistent daily intake from food or supplements is necessary to prevent deficiency.
What symptoms do you get if your folic acid is low?
Symptoms of a folic acid deficiency often develop gradually and can be subtle at first, making them easy to overlook. They typically reflect the underlying health issues caused by the deficiency, primarily megaloblastic anemia and impaired nervous system function.
General Symptoms of Deficiency
- Fatigue and Weakness: One of the most common signs, resulting from the lack of healthy red blood cells to transport oxygen efficiently.
- Irritability and Low Energy: Feeling unusually tired or lethargic and having a grouchy or irritable mood.
- Dizziness and Lightheadedness: Reduced oxygen to the brain can cause lightheadedness or a feeling of dizziness.
- Pale Skin: Fewer red blood cells can result in the skin looking paler than usual.
Oral and Digestive Symptoms
- Sore, Red, and Swollen Tongue: A smooth, red, and tender tongue, sometimes accompanied by mouth ulcers, is a classic sign of folate deficiency.
- Changes in Taste: Some individuals report a reduced sense of taste.
- Diarrhea: Gastrointestinal issues are also a possible symptom.
Neurological and Psychological Symptoms
- Pins and Needles: A sensation of tingling or numbness in the hands and feet, known as paraesthesia.
- Cognitive Impairment: Difficulties with memory, concentration, and judgment.
- Mood Changes: Low folate levels are linked to an increased risk of mood disorders, including depression and anxiety. Some studies suggest that as many as 30% of severely depressed patients have a folate deficiency.
- Other neurological issues: Problems with vision and coordination, particularly if the deficiency is prolonged.
What Causes Low Folic Acid?
A deficiency can result from several factors, often a combination of diet, lifestyle, and underlying health conditions.
- Inadequate Dietary Intake: The most common cause is not eating enough foods rich in folate, such as leafy green vegetables, citrus fruits, and legumes. Overcooking vegetables can also destroy heat-sensitive folate.
- Increased Bodily Needs: Periods of increased growth, such as during pregnancy and infancy, significantly increase folate requirements. A deficiency during pregnancy can cause severe birth defects like spina bifida.
- Malabsorption Conditions: Gastrointestinal diseases like Crohn's and Celiac disease can impair the body's ability to absorb nutrients, including folate.
- Excessive Alcohol Consumption: Chronic alcohol use interferes with folate absorption and metabolism, increasing its excretion.
- Certain Medications: Some anti-seizure drugs, medications for rheumatoid arthritis (methotrexate), and ulcerative colitis can disrupt folate metabolism.
- Genetic Factors: A mutation in the MTHFR gene affects some individuals' ability to convert folate into its active form, leading to a functional deficiency.
Diagnosis and Treatment
A folate deficiency is diagnosed through blood tests that measure the level of folate in the blood (serum folate). Your doctor will also likely check your vitamin B12 levels, as the symptoms can overlap, and folic acid supplements can sometimes mask an underlying B12 deficiency.
Treatment typically involves daily folic acid supplements for several months to restore folate levels. Dietary changes, including incorporating more folate-rich foods, are also recommended. In some cases, if the underlying cause is chronic, lifelong supplementation may be necessary.
Comparison: Folate vs. Vitamin B12 Deficiency
| Feature | Folate Deficiency | Vitamin B12 Deficiency |
|---|---|---|
| Cause | Primarily due to low dietary intake or malabsorption; also caused by increased needs (e.g., pregnancy). | Usually caused by poor absorption rather than diet (e.g., pernicious anemia, Crohn's disease); dietary issues more common in vegans. |
| Anemia Type | Megaloblastic anemia (large, immature red blood cells). | Megaloblastic anemia. |
| Neurological Symptoms | Less common, but can include depression, confusion, and peripheral neuropathy (tingling in extremities). | More common and potentially irreversible; can include memory loss, balance problems, and dementia. |
| Oral Symptoms | Smooth, tender, red tongue; mouth ulcers. | Smooth, red, and swollen tongue; mouth ulcers. |
| Diagnosis | Blood tests measure serum folate; normal B12 levels confirm folate deficiency. | Blood tests measure B12 levels; MMA and homocysteine levels can differentiate from folate deficiency. |
Conclusion: Prioritizing Folate in Your Diet
Folate is a critical nutrient for overall health, and understanding what symptoms do you get if your folic acid is low can empower you to seek help early. While fortification programs have reduced deficiency rates in some countries, many people remain at risk, especially those with certain health conditions or lifestyle factors. A balanced diet rich in leafy greens, legumes, and fortified grains is the best way to maintain adequate levels. If symptoms of fatigue, weakness, or other signs of deficiency appear, consulting a healthcare provider for a proper diagnosis and treatment plan is essential to prevent long-term complications. For comprehensive resources on maternal health and folic acid, the March of Dimes provides valuable information: https://www.marchofdimes.org/find-support/topics/pregnancy/folic-acid.
