Ensuring you get sufficient vitamins and minerals is a key part of staying healthy, and today we’re going to focus on the issue of folate deficiency. In this article, we first look at what folate is in more detail. Then we cover some common causes of folate deficiency, as well as the sort of symptoms you might experience. We also recommend plenty of delicious whole foods you can include in your diet to ensure you get enough of this vital vitamin.April 04, 2023 6:03 pm April 03, 2023 6:02 pm
What is folate?
Folate is the natural form of vitamin B9, an essential nutrient that has several key roles in the body. These include helping to make and repair DNA and RNA, produce red blood cells, and metabolize protein. Folate’s involvement in cell division and growth means it’s particularly crucial during periods of rapid development. This includes pregnancy, infancy, and adolescence.
In addition, folate is important for breaking down the amino acid homocysteine. Too much of this can have harmful effects on the body, including increasing the risk of cardiovascular disease and stroke.(1)
Our bodies are not able to make folate on their own. That means we need to obtain it from our diet in order to avoid folate deficiency. Interestingly, the word ‘folate’ comes from the Latin folium, meaning ‘leaf’. So it should come as no surprise that dark leafy vegetables are one of the best sources of the vitamin!
Technically, ‘folate’ refers to a group of compounds. The biologically active form of vitamin B9 is one type of folate called levomefolic acid, or 5-methyltetrahydrofolate (5-MTHF). Your digestive system converts most dietary folate into 5-MTHF before it enters the bloodstream. This enables your body to utilize it more effectively.
What is folate deficiency?
Put simply, a folate deficiency is when you don’t have sufficient levels of vitamin B9 in your body. This may result in a number of unwanted symptoms and side effects, which we’ll discuss below. First, however, let’s look at what can cause folate deficiency.
Folate is a water-soluble vitamin. This means that it dissolves in water, and is excreted in your urine when you have excess amounts of it. The body is unable to store folate in fat cells, and therefore can’t build up a reserve of B9. As such, you must continue to obtain folate from your diet in order to maintain healthy levels of the vitamin. If you don’t, folate deficiency can manifest in just a few weeks.
The most common cause of folate deficiency is not getting enough of it in your diet. This could be because you’re not eating foods that provide you with the vitamin, or because you’re overcooking those foods. As an example, studies suggest that boiling spinach and broccoli can reduce the amount of folate they contain by half.(2)
However, there are other reasons that you might develop a folate deficiency. For instance, certain medical conditions that affect nutrient absorption in the digestive system may prevent you from getting sufficient folate. These include celiac disease, Crohn’s disease, and specific cancers. Likewise, some types of medication can lead to folate deficiency.
In addition, some people have a genetic mutation that prevents the body from properly converting folate to its active form. This means that even if you get adequate folate in your diet, your body cannot utilize it.
Finally, drinking excessive amounts of alcohol can result in folate deficiency. That’s because it both hinders folate absorption and increases the amount of it excreted in your urine.(3)
Understanding folate deficiency symptoms
There are a number of possible indications of folate deficiency, some of which are more obvious than others. Some of the folate deficiency symptoms you may experience include:
- Growth problems
- Mouth ulcers and sores
- Grey hair
- A red, sore and/or swollen tongue
- Vision problems
- Muscle weakness
- Impaired memory, judgement and understanding
- Tingling, numbness, or pins and needles (paraesthesia)
- Peripheral neuropathy (nerve damage in the body’s extremities)
Anaemia is another common result of folate deficiency. This is a condition in which you don’t have enough red blood cells or haemoglobin to transport the oxygen you need around the body. With folate deficiency anaemia, the body produces abnormally large, oval-shaped red blood cells which are unable to function properly. This is also known as megaloblastic anaemia.
Some of the symptoms that folate deficiency anaemia can cause include:
- Pale skin
- Dizziness or feeling lightheaded
- Shortness of breath
- Muscle weakness
- A fast or irregular heartbeat
- Chest pain
Folate deficiency often occurs alongside other nutritional deficiencies. This is because causes such as a poor diet and inhibited nutrient absorption tend to affect more than one nutrient. Therefore, you may find that you experience other symptoms at the same time.
Folate deficiency and pregnancy
As mentioned above, folate is especially important during pregnancy. Vitamin B9 is crucial for a foetus to grow and develop healthily. As such, you need to take in more of it than usual to avoid folate deficiency and the associated problems.
Research has linked low levels of folate to an increased risk of birth defects related to the spine and brain.(4) These include neural tube defects and conditions such as spina bifida and anencephaly. Folate deficiency can also pose a danger to the mother by raising the chance of complications such as pre-eclampsia.(5)
One key point in this regard is that such birth defects can occur very early in pregnancy – often before you know you’re pregnant. Therefore, it’s important to avoid folate deficiency if you are of childbearing age, even if you’re not trying to conceive.
Of course, folate is necessary for many other body functions besides pregnancy. This means that people of all ages and genders should aim to avoid folate deficiency. Let’s take a look at some of the other ways this key B vitamin can boost your wellbeing.
"Our bodies can’t make folate on their own, so we need to obtain it from our diet to avoid folate deficiency. Luckily, plenty of whole foods like leafy greens and legumes are rich in this key vitamin."
How folate benefits your health
To begin with, folate could help to support the health of your heart. As mentioned above, one reason for this is that it assists in breaking down the amino acid homocysteine. This in turn works to lower the risk of heart disease and stroke. Moreover, folate may aid in reducing high blood pressure, which is another risk factor for cardiovascular disease and heart attacks.(6)
Evidence has also linked high levels of homocysteine to a greater risk of dementia and cognitive decline.(7) Although this implies that folate could work to lessen this danger, the research so far has produced mixed results.
Some studies have found that while folic acid – synthetic folate – reduces homocysteine, it doesn’t improve people’s cognitive functions. However, other research has discovered that it does have a positive effect.(8) Therefore, more investigation is required to illuminate the situation. It may be that folate benefits cognition in those who have cognitive impairment or folate deficiency, but not healthy individuals.
Speaking of the brain, studies have also discovered that folate levels are often lower in people with depression.(9) As such, there’s a chance the vitamin could be useful in treating this and other mental health conditions.
In addition, research has potentially linked a higher consumption of folate with a decreased risk of certain cancers.(10) This is likely due to its role in cell growth and making DNA. However, once again, the situation is a complicated one. Studies have also found that high doses of folic acid can actually promote tumor progression in cancer patients.(11) Further research is therefore required to clarify the impact of folate and folic acid on healthy people and those with cancer.
Finally, folate may work to improve inflammation, thus reducing the risk of numerous chronic diseases, from arthritis to diabetes.(12)
How to get folate through your diet
So, now that you know more about folate deficiency, let’s look at how to avoid it! The good news is that plenty of foods naturally contain folate. On top of which, some suppliers fortify their products with its synthetic form, folic acid. This includes items such as flour, cereals, pasta, and bread.
Some fantastic natural sources of folate include avocados, legumes like beans and lentils, and citrus fruits like oranges and grapefruit. This is in addition to dark leafy greens such as spinach and kale, and other vegetables like broccoli and asparagus. Remember that, as mentioned above, you tend to obtain more folate from vegetables when eating them raw instead of cooked.
Nuts and seeds are tiny powerhouses of nutrition, making them great for staving off folate deficiency. For instance, walnuts, sunflower seeds, almonds and flaxseeds can all help you to meet your daily B9 requirements. Munch on a handful raw, or tuck into one of our delicious oat and peanut crackers created with activated seeds. We’ve also got crunchy granola made with tigernut, sea buckthorn and sunflower seeds to kick-start your day with!
If you want a simple option to add folate to your meals, you might like our organic sea buckthorn powder. It’s rich in vitamins C and E as well as B9, plus has a zingy citrus flavor we just love! Alternatively, pick up some dried sea buckthorn berries and stir them into your favorite cakes and bakes.
Research is mixed as to whether the body absorbs natural folate or the folic acid in fortified foods more efficiently. As such, you may want to aim for a mix of both in your diet. That way, you ensure you’ve covered all your bases!
Folic acid and folate deficiency
We’ve mentioned folic acid a few times now, so it might be helpful to discuss it in more detail here. Essentially, folic acid is the synthetic version of vitamin B9. Folate, on the other hand, is its natural form. You can find folic acid in both fortified foods and supplements intended to tackle folate deficiency.
One major difference between the two is how the body converts them into 5-MTHF, the active version of vitamin B9. Unlike folate, the body metabolizes folic acid in the liver and other tissues. If you take very high doses of folic acid for folate deficiency, it might not all get converted to 5-MTHF. This can lead to a build-up of unmetabolized folic acid in the blood, which may have negative effects.(13) However, further research is required to confirm exactly what these possible health implications are.
Another factor to bear in mind is that taking large doses of folic acid may mask a vitamin B12 deficiency. This is important because if left untreated, the B12 d