What is folate?

Folate, also known as vitamin B9 belongs to the family of B vitamins. It is naturally found in many foods. It is also added to foods such as fortified cereal-grain products in its man-made form of folic acid. 

Folate is needed for a range of functions within our body. It helps our cells grow and multiply, which makes it a key vitamin in periods of rapid growth and development, such as pregnancy. Folate is particularly important in the development of the baby’s skull and spinal cord, which is why low levels of this vitamin, before and during pregnancy, can lead to severe birth defects, called neural tube defects.

Folate and vitamin B12 share many functions in the body. For example, they both work together to create our genetic material (DNA), form healthy red blood cells and support the normal functioning of our brain and nervous system.


What causes folate deficiency?

This is often due to inadequate dietary intake. Sometimes malabsorption caused by conditions such as coeliac disease, Crohn’s disease or intestinal surgery may result in folate deficiency. Certain medications as well as alcoholism may also lead to folate deficiency.  As can increased demand in pregnancy and breastfeeding. 


What are the symptoms of folate deficiency?

Most people do not have any symptoms and are often picked up incidentally when blood tests are arranged for another reason. However, long-term or severe deficiency can lead to a condition called megaloblastic anaemia that causes our bodies to form unusually large red blood cells in lower amounts. The few misshaped red blood cells have difficulties delivering enough oxygen around the body. Symptoms such as tiredness, shortness of breath, headaches, dizziness, palpitations or pale skin can develop as a result. Folate deficiency can sometimes cause a sore mouth or tongue.


Which foods are a good source of folate?

Foods that are naturally rich in folate include dark leafy green vegetables (e.g. kale, spinach, asparagus, broccoli, Brussels sprouts, cabbage) beans and legumes (e.g. chickpeas, kidney beans, peas, lentils), oranges and orange juice, wheat bran and other whole grain foods, poultry, pork, shellfish and liver (avoid this in pregnancy).

As it is a water-soluble vitamin (dissolves easily in water), it is easily lost from vegetables during cooking. This can be reduced by avoiding over-cooking, and steaming or microwaving vegetables instead of boiling.

Certain foods such as some brands of breakfast cereals are fortified with folic acid -check the label. 

How is folate deficiency treated?

In addition to improving dietary intake, folate deficiency is easily treatable and responds well to a short course of folic acid tablets, taken once a day for 3 months. There is no need to routinely re-check folate levels at the end of your treatment. 

If you are pregnant or planning a pregnancy, or have more questions, then please submit an e-consult to discuss this further.