Folate, or folic acid, is one of the water soluble B vitamins your body needs regularly for normal growth and cellular maintenance. Inadequate dietary intake and multiple medical conditions can increase your chances of becoming folate deficient. Eating a balanced diet, plus folic acid supplements as needed, can prevent and treatment folate deficiency.
The Vitamin Folate
Your body absorbs folate from food in your small intestine, with any excess excreted in the urine rather than stored in your tissues. Common natural sources of the vitamin include liver, green vegetables, citrus fruits, peas and dried beans. Most cereals, grains and breads in the United States are fortified with folic acid as well. Folate, along with vitamin B-12, is critical for the production and development of new cells in your body, assisting with DNA and RNA synthesis, red blood cell formation and normal fetal growth and development. Normal folate levels might also play a role in helping to prevent the development of cardiovascular disease and certain cancers.
Causes of Deficiency
Folate deficiency takes about four months to develop due to poor diet alone, but can appear more quickly or even on an otherwise adequate diet when a medical condition increases your body's requirements. Insufficient folic acid intake can occur with malnutrition, severely limited or fad diets, old age, alcohol use and malabsorption seen in celiac disease or inflammatory bowel disease. Your body needs extra folate during times of pregnancy, breastfeeding, inflammation, infection, injury and with certain cancers and blood disorders. Congestive heart failure, kidney dialysis and liver damage can increase the loss of folate in your urine, while various drugs including anticonvulsants and methotrexate can interfere with your body's use of the vitamin.
Detecting Folate Deficiency
Symptoms of folate deficiency include diarrhea, gray hair, stomach and mouth ulcers, poor growth in children and a sore swollen tongue, also called glossitis. The anemia of folate deficiency is characterized by enlarged, or macrocytic, red cells that look abnormal under a microscope, and often shows changes in your white cells and platelets also. Mild neurologic symptoms with tingling sensations, numbness, visual problems and confusion can occur, but are more often a sign of vitamin B-12 deficiency. The fetus is especially dependent on folate during early pregnancy because of its rapid growth and development, and deficiency can lead to brain and spinal cord abnormalities known as neural tube defects. Diagnosing folic acid deficiency involves measuring your blood folate level, and often red cell folate levels too, commonly after a routine blood count shows changes of macrocytic anemia.
Prevention and Treatment
For most people, eating a balanced diet that includes leafy green vegetables, fruit, beans, whole grains and meat provides enough folate to avoid becoming deficient. Specific daily requirements vary with your age, gender, and medical condition, especially during pregnancy and breastfeeding, and might include supplements to ensure all your needs are fulfilled. Your health care provider should also check for vitamin B-12 deficiency, which can cause many of the same signs as folate deficiency and needs to be corrected along with your folate to avoid possibly making some symptoms worse.
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