Folate Deficiency

Curated by Claudia Shannon / Research Scientist / Honayst

If you don’t have enough folate in your diet, you may end up with a folate deficiency. Certain drinks and foods, such as citrus juices and dark green vegetables, are particularly good sources of folate. Not eating enough folate can lead to a deficiency in just a few weeks. Deficiency may also occur if you have a disease or genetic mutation that prevents your body from absorbing or converting folate to its usable form.

Folate deficiency can cause anemia. Anemia is a condition in which you have too few RBCs. Anemia can deprive your tissues of oxygen it needs because RBCs carry the oxygen. This may affect their function.

Folate is particularly important in women of childbearing age. A folate deficiency during pregnancy can lead to birth defects.

Most people get enough folate from food. Many foods now have additional folate in the form of folic acid, a synthetic version of folate, to prevent deficiency. Nevertheless, supplements are recommended for women who may become pregnant.

What are the symptoms of folate deficiency?

The symptoms of folate deficiency are often subtle. They include: fatigue, gray hair, mouth sores, tongue swelling, and growth problems.

The symptoms of anemia that occur due to folate deficiency include: persistent fatigue, weakness, lethargy, pale skin, shortness of breath, and irritability.

What causes folate deficiency?

Folate is a water-soluble vitamin. It dissolves in water and isn’t stored in your fat cells. This means that you need to keep taking folate, as your body can’t develop a reserve.

People release excess amounts of water-soluble vitamins in their urine. The causes of folate deficiency include:


A diet low in fresh fruits, vegetables, and fortified cereals is the main cause of folate deficiency. In addition, overcooking your food can sometimes destroy the vitamins. Folate levels in your body can become low in just a few weeks if you don’t eat enough folate-rich foods.


Diseases that affect absorption in the gastrointestinal tract can cause folate deficiencies. Such diseases include: Crohn’s disease, celiac disease, certain types of cancers, severe kidney problems that require dialysis


Some people have a genetic mutation that hinders their body from properly and efficiently converting dietary or supplemental folate to its usable form, methylfolate.

Excessive alcohol intake

Alcohol interferes with folate absorption. It also increases folate excretion through the urine.

How is a folate deficiency diagnosed?

Folate deficiency is diagnosed with a blood test. Doctors will often test the folate levels of pregnant women during their prenatal checkups. At-home testing kits are also available.

What are the complications of folate deficiency?

Folate is required for the normal production of RBCs. Complications of a deficiency may include:

  • megaloblastic anemia, which means the RBCs are larger than normal and not fully developed
  • low levels of white blood cells and platelets
  • serious birth defects in the spinal cord and brain of a developing fetus, which are called neural tube defects

Treatment of folate deficiency

Treatment involves increasing the dietary intake of folate. You can also take a folate or folic acid supplement. Those with a genetic mutation that affects folate absorption, known as MTHFR, need to take methylated folate in order to avoid deficiency.

Folate is frequently combined with other B vitamins in supplements. These are sometimes called vitamin B complexes. Pregnant women should completely avoid alcohol, and everyone else with a folate deficiency should decrease their alcohol intake.

Prevention of folate deficiency

Eat a nutritious diet to prevent folate deficiency. Foods that contain high amounts of folate include:

  • leafy, green vegetables, such as broccoli and spinach
  • Brussels sprouts
  • peas
  • citrus
  • fruits, such as bananas and melons
  • tomato juice
  • eggs
  • beans
  • legumes
  • mushrooms
  • asparagus
  • kidney
  • liver meat
  • poultry
  • pork
  • shellfish
  • wheat bran
  • fortified cereals

Read more on: folic acid, folate