5 causes of folic acid deficiency

Are you concerned you might be low in folic acid? We discuss the signs of folic acid deficiency and what might be causing it.

Folic acid helps your body make red blood cells. These cells carry oxygen around your body.

If you don’t have enough red blood cells, your organs and tissues receive less oxygen and, as a result, they can’t work as well as they should.

When this happens, you can be suffering with folate deficiency anaemia, which can cause fatigue and make you feel weak.

5 common causes of folic acid deficiency

1. A poor diet
2. Drinking too much alcohol
3. Being pregnant
4. A condition or medication that affects the absorption of folic acid
5. Getting older

What causes folic acid deficiency in adults?

Here’s how the above factors can affect your folic acid levels.¹

Diet

Because folate is a water-soluble vitamin, it can’t be stored by your body for long periods.

Instead, any excess folic acid is released from your body in urine and perspiration.

Consequently, if you don’t eat enough folate-rich foods regularly, your body can quickly become low in folic acid.

This makes incorporating folates into your daily food choices an important part of a healthy, balanced diet.

Alcohol

Drinking too much alcohol can affect how effectively your body absorbs folates.

A condition or medication that affects the absorption of folic acid

Certain diseases affecting the stomach and intestines, such as coeliac disease, can mean your body can’t properly absorb folic acid.

In addition, some medications used to control seizures can disrupt the way your body uses the vitamin.

Pregnancy

Pregnancy can make you absorb folic acid more slowly. In addition, during pregnancy the developing baby needs this vitamin too.

This is why taking a daily folic acid supplement is recommended if there’s a chance you might become pregnant and in the first 12 weeks of pregnancy.

Folic acid deficiency in the elderly

Low levels of folates are more common in older people. It affects around 1 in 10 people aged 75 or over and 1 in 20 people aged 65 to 74.²

What are the symptoms of low folic acid?

Low levels of folate in your blood can lead to symptoms that are commonly associated with anaemia.

Anaemia symptoms³

• An absence of energy
• Severe tiredness
• Breathlessness and feeling faint
• Pale skin
• Headaches
• Palpitations
• Weight loss and loss of appetite
• Tinnitus

Folic acid deficiency symptoms in adults

In addition to the common signs of anaemia, there are some more specific symptoms of low folic acid:⁴

• Change in sense of taste
• Diarrhoea
• Pins and needles
• Muscle weakness
• Psychological problems, such as depression

What can you do if you have symptoms of low folic acid?

First of all, speak to your doctor. You’ll probably need a blood test to diagnose a folic acid deficiency and your doctor can also help you to identify your particular cause.

The best way to treat your folic acid deficiency symptoms depends on your personal trigger. Is it diet, medication, pregnancy or another condition?

However, for most people the solution is to find a way to replenish the vitamin deficit.

There are two main ways to do this: diet and supplements.

Folic acid supplements

You can restore folic acid levels by taking folic acid tablets daily until the deficiency corrects.

As a general benchmark, it usually takes around four months to address a shortage of the vitamin if it’s down to diet.⁵ 

However, if the cause is another condition or medication, you may need to continue for longer.

And if your folate levels are particularly low, your doctor may suggest an intravenous option.

Increasing folate levels through what you eat

There are lots of way to incorporate folate-rich foods into your daily diet and most people can get the folic acid they need from what they eat.

However, there are some exceptions to this, such as women who are trying to conceive or are in the early weeks of pregnancy.

Examples of foods rich in folic acid

• Leafy, green vegetables, such as broccoli and spinach
• Brussels sprouts, asparagus and peas
• Citrus fruits
• Legumes
• Mushrooms
• Meats including pork, poultry, kidney and liver
• Wheat bran
• Cereals fortified with folic acid

Summary: Are you low in folic acid?

A folic acid deficiency causes a variety of symptoms triggered by a decrease in the amount of oxygen in your body. Sometimes it can result in a condition known as folate deficiency anaemia.

Folate is a vital B vitamin, but one that your body can’t build up and store for long periods.

So rather than bolstering your reserves, any excess folic acid is excreted when you perspire or urinate.

To restore healthy levels of this vitamin you may need to increase your regular daily intake, either from food or a dietary supplement.

But first, seek advice from your doctor to check supplements are right for you and your circumstances.

Last updated: 10 June 2021