What is folate?
Vitamin B9 (folate) is a water-soluble essential vitamin that you must get from your diet. Folate is required for normal red blood cell (RBC) formation, repair and development of tissues and cells, and synthesis of DNA. Folate is especially important for pregnant women because a deficiency can lead to defects in the growing baby.
Folate is required, along with vitamin B12 (cobalamin) and Vitamin B6 (pyridoxine), to keep homocysteine (an amino acid that is harmful if too high in the blood) in check and for the formation of so-called methyl groups, which are involved in many bodily processes.
Why test folate (vitamin B9)?
Folate can be a relevant test if you are pregnant or planning to become pregnant, if you don't eat many fruits and vegetables; if you smoke, take drugs or drink excessive alcohol, if you have a condition associated with malabsorption, like celiac disease or IBD. Some medicines increase your need for folate. Some people like to check their folate levels to ensure optimal levels.
More information
Folate can be measured in serum, in whole blood and in red blood cells. Two recent studies have shown that the amount of folate in serum correlates well with red blood cell folate and may even be a better test. Therefore, based on current evidence we recommend and offer serum folate.
What causes low folate?
You have lower folate in your blood than expected. Folate works alongside vitamin B12 and Vitamin C to help the body break down, use, and make new proteins. It also helps in the formation of red and white blood cells and helps to produce DNA. Since folate is water-soluble, it is not stored in the body’s fat tissues and is disposed of through the urine. Blood levels decrease after just a few weeks on a low folate diet.
Causes of low folate include lack of folate in the diet, overcooking vegetables, diseases that reduce the absorption of folate, excessive alcohol consumption, hemolytic anaemia, certain medications, kidney dialysis, or malabsorption. There are several potential reasons for this, including celiac disease, inflammatory bowel disease (Crohn’s disease and ulcerative colitis), bacterial overgrowth, intestinal parasites, reduced stomach acid, pancreatic insufficiency, heavy drinking/chronic alcohol use, increased need, and smoking.
Symptoms of low folate
Low folate levels can lead to fatigue, weakness, pale skin, shortness of breath, and irritability. It can also cause digestive issues like diarrhea and a sore tongue. In severe cases, it may result in anaemia and cognitive difficulties.
What causes high folate?
High folate levels may indicate high consumption of fortified foods or excessive supplementation. Consuming more folate than you need does not necessarily cause health problems. High folate levels can also indicate vitamin B12 deficiency, especially if you do not supplement and your diet is not high in folate-rich foods. The body needs B12 to use folate properly.
Symptoms of high folate
High folate levels are generally not harmful, but excessive intake can mask symptoms of vitamin B12 deficiency, potentially leading to neurological issues. It's important to balance folate intake to avoid complications related to hidden deficiencies.
Preparations for this test
The day before
Do not eat or drink anything except water for 12 hours before taking this test, as folate is best taken as a fasting test.
On the day of the test
Always take I.D. with you when taking a test.