Folate (folic acid)

What is folate?

Folate is the name for vitamin B9 in its natural form. The synthetic variant, found in dietary supplements and fortified foods, is called folic acid. Both forms perform similar functions in the body, but are absorbed and processed slightly differently.

This vitamin plays a central role in the production of DNA and RNA, the building blocks of every living cell. Without sufficient folate, the body cannot regenerate properly. This is particularly noticeable in rapidly growing tissues, such as bone marrow and the intestinal lining.

Folate works closely with vitamin B12. Both vitamins are necessary for the correct production of DNA and the formation of red blood cells. They activate each other mutually: folate helps convert certain substances into the active form of B12, while B12, in turn, converts folate into a usable form. A deficiency in either can therefore disrupt the function of the other.

Why is folate measured?

A folate test in the blood provides insight into your nutritional status and shows whether your body is getting enough of this vitamin. Doctors use this test to detect a possible deficiency, but also to monitor the progression of certain conditions, such as anemia and chronic inflammatory diseases.

An adequate folate level is particularly important during pregnancy. A deficiency in the early weeks of pregnancy increases the risk of spina bifida and other neural tube defects in the fetus. Therefore, women wishing to conceive are advised to start taking folic acid supplements even before conception.

Folate is also measured if there are suspicions of absorption problems, such as with celiac disease or Crohn's disease, or when someone is taking medication that affects folate metabolism, such as certain anti-epileptics or methotrexate.

What do abnormal values ​​mean?

Low folate value

A value that is too low indicates a deficiency and often has a nutritional cause. A one-sided or poor diet, excessive alcohol consumption, or old age are common risk factors. A deficiency can also occur in diseases where absorption in the intestines is impaired, such as celiac disease or Crohn's disease.

Sometimes the body consumes more folate than normal. This is the case during pregnancy, with hemolytic anemia (where red blood cells are broken down more rapidly), with myeloproliferative disorders, or with chronic inflammatory diseases. A deficiency can manifest as fatigue, tingling or numbness in the hands and feet, sleep problems, depression, and concentration difficulties.

High folate level

An elevated folate level is generally not a cause for concern and, in most cases, indicates the use of supplements or fortified foods. It is virtually impossible to consume too much folate through a normal diet.

A special situation arises with a vitamin B12 deficiency. Because folate and B12 influence each other, a B12 deficiency can sometimes lead to an apparently elevated folate level in the blood. The folate accumulates because it cannot be processed properly. This emphasizes why it is useful to assess both values ​​together.

Folate and diet: how much do you need?

Folate is naturally found in many plant-based foods. Good sources include legumes such as beans, lentils, and chickpeas, as well as various types of cabbage, dark green leafy vegetables, fruit, and berries. Whole-grain products, skim milk, and yogurt also contain a substantial amount.

For adults and adolescents aged 14 and over, the recommended daily intake is approximately 300 micrograms. For pregnant or breastfeeding women, the recommendation is 500 micrograms per day. Despite a varied diet, many people in practice consume too little folate, which underscores the importance of conscious dietary choices.

Folate also works in conjunction with ferritin, the protein that stores iron in the body. Both substances are necessary for healthy blood formation. A folate deficiency reduces the production of red blood cells, while an iron deficiency leads to iron-deficiency anemia. It is therefore advisable to have both values ​​checked if you experience symptoms that may indicate anemia.

When is testing useful?

A folate measurement is useful if you suffer from persistent fatigue, tingling in the limbs, concentration problems, or a feeling of depression without a clear cause. It can also be useful to monitor your folate levels if you follow a one-sided diet, have intestinal problems, or take certain medications.

For women who want to become pregnant, measuring folate levels is a logical step in the preparation. A timely measurement makes it possible to correct a deficiency with supplementation well before the first weeks of pregnancy begin. Those first weeks are the most critical for the development of the fetus's nervous system.