While folate is present in many foods, not everyone gets enough in their diet. Even when they do, absorption can be problematic due to issues like poor digestion (specifically malabsorption disorders) or genetic concerns that make it harder to convert dietary folate and supplemental folic acid into a usable form.
Read on to learn more about the signs of folate deficiency, the health benefits of folate, common causes of folate deficiency, top folate-containing whole foods, and recommended doses of folic acid supplements.
Signs of Folate Deficiency
There are several common symptoms of folate deficiency:
Fatigue and Low Energy
Feeling tired or weak without a clear reason? Low energy might be due to folate deficiency. This is often linked to anemia, which folate deficiency can cause.
Hearing Loss
A 2010 study found a connection between age-related hearing loss and low folate levels in the blood. If you’re over 60 and experiencing hearing loss without a clear diagnosis, a folate deficiency might be the cause.
Anemia
Anemia, a shortage of red blood cells, can make you feel tired and weak. It can also cause shortness of breath and an increased heart rate as your body struggles to transport enough oxygen. Anemia can have various causes, including internal bleeding, heavy menstruation, serious illnesses, genetic diseases, and nutritional deficiencies, especially low iron, B12, and folate.
Shortness of Breath
Difficulty breathing or feeling winded with mild exertion can also be a sign of folate deficiency, often due to anemia.
Memory Loss
Cognitive impairment, including memory issues and dementia, is linked to lower folate levels, especially in older adults. Some studies suggest that folic acid supplementation can improve cognitive function.
Pale Skin
Pale skin can be a symptom of anemia caused by folate deficiency.
If you’re experiencing these symptoms, ensure you’re getting enough folate in your diet and consider taking a folic acid supplement. If symptoms persist, see your doctor.
Folate vs. Folic Acid
Folate and folic acid are both forms of vitamin B9, but they come from different sources. Folate is the natural form found in foods like nuts, leafy greens, and other fruits and vegetables. Folic acid is the synthetic form added to foods like enriched cereals and flours since 1998 due to FDA requirements. While you can get enough folate from a healthy diet, fortified foods and supplements can help ensure adequate intake.
Folate and Folic Acid Benefits
Consuming enough folate and folic acid offers several health benefits:
Facilitates New Cell Production
Folate is crucial for producing and maintaining new cells, including red blood cells, because it’s needed for DNA replication and protein synthesis.
Promotes Normal Blood Pressure
For people with high blood pressure, folic acid may help prevent strokes. A 2015 study in the Journal of the American Medical Association found that folic acid supplements reduced stroke risk in adults with high blood pressure.
Helps Healthy Development of Fetus During Pregnancy
Adequate folic acid intake is critical during pregnancy to prevent neural tube defects (NTDs) like spina bifida. The CDC recommends that women of childbearing age consume at least 400 micrograms of folic acid daily.
Encourages a Healthy Heart
High homocysteine levels, a marker for heart disease risk, can be reduced with adequate B vitamins, including folate. The Nurses’ Health Study found that women with high dietary intake of B6 and folate had a lower risk of heart disease.
Helps Protect Your Bones
Folate deficiency can lead to elevated homocysteine levels, which increase the risk of bone fractures. Adequate folate intake can help maintain bone health.
What Causes Folate Deficiency
Common causes of folate deficiency include:
A Defect of the MTHFR Gene
People with an MTHFR gene defect struggle to convert dietary folate and folic acid into a usable form, leading to deficiency despite adequate intake.
Poor Digestion Due to a Malabsorption Disorder
Conditions like celiac disease can prevent proper nutrient absorption, causing folate deficiency.
Alcoholism
Long-term alcohol consumption can impair nutrient absorption and increase folate excretion, leading to deficiency.
Pregnancy and Breastfeeding
Increased demand for folate during pregnancy and breastfeeding can lead to deficiency.
Medications
Certain medications, like metformin and birth control pills, can cause folate deficiency.
Top Foods High in Folate
Kale, spinach, collard greens, lentils, asparagus, Brussels sprouts, and nuts are excellent sources of natural folate. For example, one cup of spinach contains 263 micrograms of folate, about 65% of the U.S. RDA.
How Much Folic Acid Should You Take?
The U.S. RDA for folic acid is:
– Infants 0-6 months: 65 mcg
– Infants 7-12 months: 80 mcg
– 1-3 years: 150 mcg
– 4-8 years: 200 mcg
– 9-13 years: 300 mcg
– 14+ years: 400 mcg
– Pregnant women: 600 mcg
– Breastfeeding women: 500 mcg
Most adults get enough folate from their diet, but the CDC recommends that women of childbearing age take 400 micrograms of folic acid daily to prevent birth defects. Supplements are also recommended for those not consuming enough folate-rich foods, those with malabsorption disorders, or those taking medications that affect folate levels.
Points to Remember
If you’re experiencing unexplained fatigue, shortness of breath, memory loss, or age-related hearing loss, folate deficiency could be the cause. Prevent deficiency by eating folate-rich foods like dark leafy greens, beans, nuts, and citrus fruits. Consider methylated folate supplements if you have an MTHFR gene defect. Women of childbearing age should take a folic acid supplement to ensure adequate blood folate levels for a healthy pregnancy. Folic acid supplementation also supports energy levels, reduces stroke risk, and protects bones, hearing, and memory.
