Folic acid, also known as folate or vitamin B9, is a member of the B complex family. Dark green leafy vegetables, such as spinach and kale, are good food sources of folic acid. Like other B vitamins, folate is water-soluble, so excess amounts are usually eliminated in your urine. However, nutritionist Elson Haas, M.D., states that your liver stores enough folic acid to support six to nine months of normal physiologic activity. Despite this, Haas contends that folate deficiency could be one of the most common vitamin deficiencies.
Functions
Most of the folic acid in your body is in an inactive state called methyl folate. Vitamin B12 converts methyl folate to tetrahydrofolic acid, or THFA, which is the vitamin's active form. THFA is instrumental in the production of hemoglobin, which is the oxygen-carrying protein in your red blood cells. THFA is required for the synthesis of DNA and RNA, so your needs for folate increase in conditions requiring the rapid production of cells, such as pregnancy or cancer. Folate also participates in amino acid metabolism, and it helps to balance neurotransmitter levels in your brain. Tissues that turn over rapidly, such as blood cells and mucous membranes, are particularly sensitive to folate deficiency.
Deficiency
"The Merck Manual of Diagnosis and Therapy" reports that folate deficiency most commonly occurs as the result of poor intake, poor absorption or increased metabolic demand. Alcoholism, advanced age, pregnancy, celiac disease and the use of antibiotics or birth control pills increase your risk for deficiency. Signs and symptoms of folate deficiency include anemia, fatigue, loss of appetite, irritability, headache, depression, diarrhea and sore mouth and tongue. Insufficient intake of folate during pregnancy contributes to neural tube defects, which are abnormalities in the fetal brain and spinal cord.
Sore Tongue
Atrophic glossitis, or a smooth, sore tongue, is occasionally caused by folic acid deficiency. The surface of your tongue sloughs and renews itself frequently, which requires regular replacement of the cells along its outer layers. Folic acid deficiency interferes with the synthesis of DNA that is needed for this cellular regeneration. However, as outlined in the March 2010 "American Family Physician," glossitis can be caused by other conditions, such as vitamin B12, iron, riboflavin or niacin deficiencies, Sjögren's syndrome and other autoimmune disorders, celiac disease, protein-calorie malnutrition, drug reactions and local or systemic infections.
Considerations and Recommendations
Recommended dietary allowances for folate vary from 65 mcg for infants to 600 mcg for pregnant women. Folic acid deficiency is only one of many potential causes of a sore tongue. Other signs and symptoms of folate deficiency often precede or accompany a sore tongue, so an isolated case of glossitis could well be due to another condition. Thus, a persistent case of glossitis should prompt a visit to your doctor.
References
- "Staying Healthy with Nutrition: Folic Acid (Folate or Folacin); Elson M. Haas, M.D.; 2006
- "The Merck Manual of Diagnosis and Therapy, 18th Edition: Folate"; Mark H. Beers, M.D., Editor-in-Chief; 2006
- "American Family Physician"; Common Tongue Conditions in Primary Care; B.V. Reamy, et al.; March 2010
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