Folate, also known as vitamin B9, is an essential nutrient required for many vital bodily functions. A folate deficiency can lead to a range of health issues. This article by healthcare nt sickcare will cover what is folate, the causes and symptoms of its deficiency, and the importance of testing folic acid levels.
What is Folate?
Folate is a B-complex vitamin naturally found in many foods. It plays a key role in:
- Cell division and growth
- DNA and RNA synthesis
- Amino acid metabolism
- Red blood cell formation
Without adequate folate, the body cannot properly produce and maintain new cells. Folate is especially critical during periods of rapid cell division and growth like in infancy and pregnancy.
Folate is also vital for a process called methylation, which involves DNA expression and protein metabolism. It helps convert homocysteine, an amino acid, into methionine, another essential amino acid.
The synthetic form of folate used in supplements and fortified foods is called folic acid. Once absorbed, the body converts folic acid into the active folate form it can utilize.
Causes of Folate Deficiency
Some key causes of low folate levels include:
- Poor dietary intake: Not eating enough folate-rich foods like leafy greens, legumes, citrus fruits, liver and fortified cereals can lead to deficiency over time.
- Malabsorption issues: Health conditions like celiac disease, inflammatory bowel disease and alcoholism can impair folate absorption from foods.
- Pregnancy: The rapidly growing fetus has a high demand for folate, so mothers can become deficient if intake is inadequate.
- Certain medications: Drugs that interfere with folate metabolism, like methotrexate and trimethoprim, increase the risk of deficiency.
- Genetic mutations: Some people have MTHFR and other gene mutations that affect the utilization of dietary folate.
- Dialysis treatment: Folate is lost during hemodialysis used to treat kidney failure.
- Low vitamin B12 status: Vitamin B12 helps convert folate into its active form, so B12 deficiency can result in functional folate deficiency.
Symptoms of Folate Deficiency
Folate deficiency can manifest with an array of symptoms, although mild cases may have no obvious signs:
- Fatigue, weakness and low energy
- Heart palpitations
- Shortness of breath
- Headaches and irritability
- Sore tongue
- Changes in skin, hair or fingernails
- Forgetfulness and difficulty concentrating
- Depression and mood changes
Deficiency severe enough to produce anaemia can also cause symptoms like:
- Pale skin
- Sore mouth and tongue
In infants and children, folate deficiency can impair growth and cause developmental delays.
Importance of Testing Folic Acid Levels
Folate testing is important for:
- Diagnosing Folate Deficiency: Blood testing can detect low folate levels before major symptoms appear. This allows early treatment to prevent complications. Folic acid and homocysteine lab tests are used to evaluate folate status.
- Monitoring High-Risk Groups: Testing folate status is crucial in those at increased deficiency risk like pregnant women, anemics, alcoholics and people with absorption disorders. This identifies who needs more aggressive folate supplementation.
- Adjusting Folic Acid Intake: Testing determines who needs more dietary folate or folic acid from supplements or fortified foods. Folate requirements increase during pregnancy and can vary with medical conditions and genetics. Testing tailors folic acid intake to individual needs.
- Assessing Unexplained Anemia: Since folate deficiency can impair red blood cell production, folic acid testing is an important part of evaluating unexplained anaemia. Ensuring adequate folate helps optimize response to iron supplements.
- Checking Supplementation Effectiveness: Periodic folic acid testing verifies that those on supplementation for deficiency are taking enough to restore normal folate levels but not excessive amounts.
Routine folic acid testing is recommended for:
- All women planning a pregnancy or early pregnancy.
- People with conditions causing malabsorption like celiac or IBD.
- Those on kidney dialysis or drugs that deplete folate.
- Adults over 50 years to check food/supplement intake.
- Anyone with symptoms potentially related to folate deficiency.
Folate testing is done through a routine blood draw. No special preparation is required. Normal serum folate levels are >5.38 ng/mL in adults. Values below 3 ng/mL confirm folate deficiency.
Improving Low Folate Levels
If folate testing reveals inadequate levels, the following tips can help increase your folic acid intake:
- Increase dietary folate by eating more greens, legumes, citrus fruits and fortified cereals.
- Take a folic acid supplement providing 400-800 mcg per day.
- If you have a MTHFR gene mutation, opt for the L-methylfolate form.
- Treat any underlying digestive disorders impairing folate absorption.
- Check for vitamin B12 deficiency and supplement B12 if low.
- Avoid alcohol which impairs folate metabolism.
Retesting folic acid levels periodically ensures levels normalize with adequate intake. Please contact us if folate testing is needed to assess any symptoms possibly related to deficiency.
Frequently Asked Questions
Folate deficiency can lead to anemia, fatigue, neurological issues and birth defects.
Why check folic acid levels during pregnancy?
Folate needs to increase during pregnancy to support rapid fetal growth and development. Testing folate status ensures pregnant women take adequate folic acid to prevent deficiency, which can lead to birth defects and complications.
When is the ideal time for women to start taking folic acid supplements?
Ideally, women should begin taking 400-800 mcg of folic acid supplements at least one month before conception and continue through the first trimester. This ensures protective folate levels even before pregnancy is confirmed.
How often should folic acid levels be checked?
Those at risk of deficiency should have folic acid levels monitored regularly, such as every 3–6 months. People taking folic acid supplements may need less frequent testing, such as yearly, to ensure adequate levels are maintained.
Do multivitamins provide enough folic acid?
Multivitamins typically contain only 400 mcg of folic acid. For many high-risk groups, a separate folic acid supplement with 800 mcg or more ensures adequate daily intake on top of multivitamins.
What factors can affect folic acid test results?
Recent intake of folic acid supplements can artificially inflate results. Certain medications also influence folate levels. Discuss your health history with your doctor and avoid supplements for a few days before testing whenever possible.
At healthcare nt sickcare, our lab provides reliable folic acid testing to assess your folate status. Please contact us or book online if you require folate testing.
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