Folate deficiency is one of the most common vitamin deficiencies affecting people in the UK, with an estimated 1 in 8 at risk of experiencing it. In this article, Supplement Hub’s in-house practitioner Josephine Smith (BsC Health Science) explains what folate deficiency is, the leading causes, signs of folate deficiency to look out for and what to do if you’re concerned you may be suffering with this.
What is Folate Deficiency?
Folate deficiency occurs when there is a sustained lack of vitamin B9 in our bodies. Vitamin B9 or folate, is a crucial vitamin for a number of reasons including helping to produce healthy red blood cells, helping cells divide and aiding DNA synthesis. Folate naturally occurs in our food, while folic acid is a synthetic supplement taken to help support optimal intake. To help you make the right choice for your personal health goals, we’ve penned an in-depth guide for more information on the differences between folate and folic acid.
What Causes Folate Deficiency?
There are a number of causes for folate deficiency, primarily insufficient intake through diet alone or poor absorption; usually due to medical conditions affecting the gut such as Coeliac disease or Crohn’s disease. Other common causes of folate deficiency include: side effects of medications impacting the body, certain medical treatments, high alcohol intake, and an increase in demand during periods such as pregnancy.
What is the Normal Folate Level in Adults?
Folate levels are detected using a folate blood test, measuring the amount of serum (blood) folate or red blood cell (RBC) folate in the blood. RCB folate levels represent the long term folate status and give a better overview of historic folate levels, indicating the possibility of a deficiency. The ‘normal’ ranges for blood folate are often banded as follows:
- < 4 ng/mL → folate deficiency likely
- 4–7 ng/mL → low / borderline
- > 7 ng/mL → generally considered adequate
RBC folate reflects long-term folate status. The Typical reference range to determine RCB levels is within ~150–600 ng/mL. If the level falls below ~150–200 ng/mL this often indicates the presence of a folate deficiency.
What is the Normal Folate Level for a Woman?
In women, the normal ranges of serum folate are between 10–20 ng/mL. Maintaining folate levels within this range supports the body in a multitude of ways including:
- Supporting optimal methylation pathways
- Helping to maintain healthy homocysteine levels
- Supporting red blood cell formation and energy metabolism
- Supporting regular hormonal balance and reproductive health
Low folate levels in women fall below ~8–10 ng/mL, even if still within conventional laboratory limits. However, demand will fluctuate more during a woman’s lifetime than a man’s due to differences in reproductive health so women require higher levels of folate during pregnancy or prime reproductive years.
What is the Normal Folate Level for a Man?
Usually, the levels of normal folate for men and women are the same. However, sometimes certain health conditions such as Crohn’s disease or MTHFR gene mutations can impact the level of supplementation needed in certain individuals to meet intake requirements. Generally, practitioners apply the same normal or optimal ranges for both men and women, but women may be monitored more closely due to considerations associated with reproductive health.
Folate Deficiency Symptoms
The symptoms of folate deficiency typically develop gradually but worsen over time, causing long term health effects if left untreated. These signs of folate deficiency typically become apparent after a while as the body experiences a reduction in cell production which can affect health in a multitude of ways. It’s important to discuss any concerning symptoms with your GP or health care provider to establish folate deficiency as a cause, or rule out any other deficiencies or anaemia which are common alongside folate deficiency.
What are the Symptoms of Folate Deficiency?
Folate deficiency can often be identified as a possible cause for ill health by recognising the common symptoms associated with low folate levels. The symptoms of folate deficiency to look out for are:
- Extreme tiredness / fatigue
- Headaches
- Shortness of Breath / Breathlessness
- Mouth Ulcers
- Cognitive Issues
- Stomach upset (nausea and Diarrhea)
- Digestive Issues
What are the Long Term Side Effects of Folate Deficiency?
If left untreated for prolonged periods, folate deficiency can surpass the immediate symptoms and begin having long term effects on the body. As well as recognising the symptoms to watch for, it’s equally important to understand how this impacts the body long term to understand the full spectrum of symptoms.
| Long Term Effect | How it Affects your Body |
| Neurological Issues | Consistent deficient levels can impact your cognitive health resulting in memory loss, mood dysregulation (depression etc) confusion and can contribute to dementia progression. |
| Cardiovascular Issues | Prolonged levels of low folate can increase the risk of cardiovascular illness such as heart disease and heart failure or increase. |
| Pregnancy Complications | As an essential vitamin for pregnancy, low folate in pregnant women significantly increases the risk of neural tube defects in the foetus, as well as premature labour/birth and underdevelopment (low birth weights). |
| Gastrointestinal Problems | Untreated levels of low folate can cause long lasting changes to your gastrointestinal health such as diarrhea. |
| Oral Issues | Prolonged folate deficiency can cause oral discomfort, sores, gum issues and other painful oral issues. |
Folate Deficiency Treatment
Treatment for folate deficiency typically involves regular intake of folic acid supplements for a period of at least 4 months. Alongside regular supplementation, for cases with moderate to severe folate deficiency dietary and lifestyle changes are often recommended to improve the intake they are achieving through diet and prevent repeated issues.
As well as adequate treatment, outlining the cause and making lifestyle changes to eliminate further risk is also recommended to ensure you’re not at continued risk once treatment has finished.
As with any supplementation or medical concern, we recommend a thorough consultation with your GP to identify any underlying causes and establish tailored treatment and lifestyle advice.
Supplements for Supporting Folate Deficiency
As we’ve mentioned, supplements, such as folic acid, are recommended for combatting folate deficiency and helping your body achieve the recommended intake. However, there are a range of other supplements you can take to help complement folic acid, aid absorption and support health in the areas affected by folate deficiency.
Below, we’ve hand-picked some of the best vitamins to take to support folate deficiency:
| Supplement | How this Helps Folate Deficiency | Recommended Dosage |
| Folic Acid | As the synthetic form of folate (vitamin B9) this is the most effective treatment for folate deficiency, helping the body achieve the right daily amount. | Women of reproductive age: 400–600 mcg per day Pregnant women ~600 mcg per day Women who are breastfeeding ~500 mcg per day Your health care provider may prescribe you a temporary higher dose in cases of severe folate deficiency or folate-deficiency anaemia. |
| Vitamin B Complex | A formulation of all B vitamins, boosting energy levels, supporting metabolic health, improving cognitive function and promoting healthy cell growth. | Typically 400mcg of vitamin B9 present in high quality formulations. |
| Iron | Low iron can also contribute to folate anaemia symptoms/complications. | Iron supplements are usually only required when iron levels are low alongside folate deficiency, with the dosage varying between 18-65mg daily. |
| Vitamin C | Improves absorption of iron and other supplements | Typically between 250 and 500mg daily. |
High-Quality Supplements, Trusted by Experts and Backed by Science
At Supplement Hub, we work closely with our team of internal practitioners to ensure that all of our products are backed by science and trusted by medical experts; giving you peace of mind when you need it. We’ve curated a collection of the best quality vitamins and supplements from trusted brands such as Seeking Health, BioCare and Pure Encapsulations, all hand-picked by our medical experts to help you fuel your body with confidence.
Whether you’re looking for support across a variety of health areas or preparing your body to transition through a new period such as pregnancy, menopause, or conception we’ve got you covered with our high-quality supplements.
