As a natural B vitamin that helps the body make blood cells and DNA, folate is an important nutrient — so important, in fact, that the U.S. Food Administration (FDA) has required that its synthetic version, folic acid, be added to grocery foods like bread and pasta since the 1990s.
But despite public health efforts to fortify the American diet with this essential vitamin, some people still aren’t getting enough, which puts them at risk for folate or folic acid deficiency symptoms and related health problems.
If you think this may apply to you, this guide’s here to help. Here’s what causes folate deficiency, what it feels like and how to manage this rare but potentially serious condition.
Folic acid deficiency causes
Some causes of folate deficiency may be within your control, such as not eating enough fruits and vegetables, overcooking the nutrients out of food or drinking too much alcohol.
However, other causes may be outside of your control. These factors may include taking certain medications, undergoing dialysis or having diseases such as Celiac or Crohn’s that make it more difficult for the body to absorb folic acid.
Folic acid deficiency symptoms
If you have a folic acid deficiency, you might not know it at first. The signs can come gradually and mimic other common symptoms such as feeling tired, irritable or dizzy.
These symptoms indicate folate-deficiency anemia, a condition that happens when the body’s lack of folate or folic acid limits the production of red blood cells. More severe cases of folate deficiency can cause changes in the tongue (such as redness, pain or reduction in taste ability), weight loss, diarrhea or depression.
As the condition progresses, it may turn into pancytopenia, a potentially life-threatening disease where the body doesn’t have enough red blood cells, white blood cells or platelets.
Because of folate’s role in developing babies, folic acid deficiency in pregnant people can lead to serious problems, including neural tube defects. That’s why the recommended daily values of folic acid are higher for pregnant people, at 600 micrograms (mcg), compared to the recommended 400 mcg in nonpregnant adults or those who may become pregnant. Most people can achieve that with a combination of natural food sources, such as fruits and vegetables, and oral supplements.
How to increase your folate and folic acid intake
Whether you’re folate-deficient or not, it’s a good idea to choose foods rich in this B vitamin, including citrus, leafy greens like spinach, broccoli and asparagus, and foods fortified with folic acid. Where possible, choose raw but washed fruits and vegetables, as the heat used in cooking can eliminate up to 95% of the folate in food.
If you may become pregnant or are planning to become pregnant soon, do all of this in addition to taking a prenatal vitamin with at least 400 mcg to help supplement the folate you get naturally from food. It’s good for you and your unborn baby.
However, even with a good diet, it’s best for everyone to check with their doctor if they suspect they may be experiencing symptoms of a folate/folic acid deficiency. Your doctor can run a blood test to screen for this, explore possible underlying problems and develop a treatment plan to help prevent serious effects.
Fortunately, treating folate deficiency can be done effectively by taking folic acid supplements, so even though it may be a slow process to find out whether there’s a problem, once you’ve identified the issue, the cure is likely just around the corner at your local grocery or drugstore.
Want to talk to someone about your folic acid intake? Search for a primary care physician  at one of our many locations to get the conversation started.