Folate or folic acid is one of the essential vitamins from the Vitamin B complex. Folate deficiency occurs when there is lack of folic acid in the body. As folate is involved in making blood cells, deficiency of folate shows symptoms related to decreased blood cells and hemoglobin and folic acid deficiency anemia is commonly present. Know the symptoms of folate deficiency to be aware, so that necessary steps can be taken to prevent further health problems.
The main function of folate, as a part of Vitamin B group is to produce red blood cells, make and repair DNA. Folate is important during pregnancy to ensure normal growth of the developing fetus. It plays a major role in development of brain and spine. Regular intake of folic acid is particularly essential during pregnancy and other phases of normal recovery of the body.
Folate is present in dark green leafy vegetables like spinach, broccoli, sprouts, beans, peas, wholegrains, fortified cereals, citrus fruits, oranges and bananas.
Symptoms of Folate Deficiency
Symptoms of folate deficiency can show features of anemia and vitamin B12 deficiency. Some of the folate deficiency symptoms commonly seen include:
- Tired feeling or fatigue, lethargy and lack of energy, getting fainted or breathless with least exertion can be symptom of folate deficiency.
- Greying of hair, brittle hair or easy falling of hair, mouth ulcers or sores, redness or soreness of tongue, altered taste sensation and bowel disturbances are also folate deficiency symptoms.
- Some people with folate deficiency may have symptoms of lightheadedness, ringing in ears or headaches and palpitations. Experiencing loss of appetite and weight loss too is common.
- People with folate deficiency may appear pale, unenergetic and sometimes even depressed. Increased irritability, confusion, difficulty in concentration, behavioral changes, alteration in thinking patterns, difficulty to comprehend, judge and remember can also result from folate deficiency.
As folate is involved in growth, development and repairing of body cells, folate deficiency can also affect growth in some cases.
Folate deficiency when present in addition to vitamin B 12 deficiency may also show neurological symptoms like numbness and tingling in hands or legs, changes in vision or visual disturbances.
In chronic or long standing cases of folate deficiency, gastrointestinal disturbances can occur, which can also lead to bleeding in the gastrointestinal tract, requiring immediate medical attention. Some studies have related folate deficiency with increased risk of certain type of cancers, which include gastrointestinal cancers like colon and rectal cancer.
Folate Deficiency Symptoms in Pregnancy
During pregnancy the demands for folic acid increases in order to meet the requirements of the growing fetus. If enough folate is not received through a balanced diet or supplementation, red blood cells carrying oxygen are affected and may result in folate deficiency anemia.
The symptoms of folate deficiency in pregnancy commonly include fatigue, lethargy and fainting. As folate is important for brain development of the fetus, folate deficiency in pregnancy can lead to birth defects, more commonly neural tube defects like spina bifida. Sometimes, folate is also thought to be important in order to prevent other health concerns like preterm birth, growth retardation and low birth weight babies.
Causes of Folate Deficiency
Certain factors can increase the risk of folate deficiency. Folate deficiency is a result of:
- An inadequate diet, which fails to meet the daily folic acid requirements. This includes inadequate intake of folate rich foods like green vegetables, peas and beans, brown rice, etc.
- Certain disorders that affect proper absorption of vitamins and minerals like celiac disease or other malabsorption syndromes.
- Inflammatory conditions like, inflammatory bowel disease, etc. too can cause low folate levels.
- Conditions that increase the folate demand. For e.g. pregnancy or certain blood disorders increase the risk of folate deficiency if proper diet is not taken.
- Certain medications used to treat rheumatoid arthritis or certain types of cancers can cause deficiency of folate.
Treatment & Management of Folate Deficiency
Treatment of folate deficiency involves taking folate medications, mostly in the form of tablets every day to meet the daily requirements. The dose and duration may vary depending on the cause of folate deficiency.
Folic acid is supplemented to pregnant ladies during the first 12 weeks and may be continued till term. In case of planned pregnancies, folic acid supplementation should ideally begin around the time of conception to ensure good stores of folate throughout pregnancy.
In case of absorption related disorders, the underlying conditions should be treated along with folate supplementation. If medications known to cause folate deficiency are the cause, they can be changed or additional folate supplementation can be given.
Prevention of folate deficiency can be achieved by giving prophylactic folate supplementation a consideration in pregnant women having a previous child with neural tube defect, women planning their pregnancies, those with blood disorders, those taking medicines like methotrexate for rheumatic disorders and those undergoing dialysis.
- National Health Service (NHS). (2021). Folic Acid. Retrieved from https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-b/
- National Institute of Health. (2021). Folate. Retrieved from https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
- Mayo Clinic. (2021). Folate (Folic Acid). Retrieved from https://www.mayoclinic.org/drugs-supplements-folate/art-20364625
- American Pregnancy Association. (2022). Folic Acid and Pregnancy. Retrieved from https://americanpregnancy.org/pregnancy-health/folic-acid-and-pregnancy/