What is Folate?

Folate, also known as Vitamin B9, is a water-soluble B vitamin essential for DNA synthesis, cell division, and methylation—a crucial process for detoxification and gene regulation. It plays a key role in red blood cell formation, brain function, and fetal development. Folate works in tandem with Vitamin B12 and B6 to keep homocysteine levels low, reducing the risk of cardiovascular disease.

Since the body cannot store large amounts of folate, it must be consumed regularly through diet or supplements. Natural sources include leafy greens, citrus fruits, beans, and fortified grains. Folate is especially important during pregnancy, where it helps prevent neural tube defects and supports fetal development.

Factors That Influence Folate Levels

1. Dietary Intake

Folate is naturally abundant in leafy greens (spinach, kale, romaine lettuce), citrus fruits (oranges, lemons), legumes (lentils, chickpeas), and fortified foods (cereal, bread, and pasta). A diet lacking in these foods can lead to deficiencies.

2. Absorption Issues

Certain medical conditions and lifestyle factors can impair folate absorption, including:

• Celiac disease and Crohn’s disease, which damage the gut lining.
• Alcohol consumption, which interferes with absorption and increases folate loss.
• Medications like methotrexate, metformin, and antacids, which may reduce folate levels.

3. Pregnancy and Increased Demand

During pregnancy, folate needs increase significantly to support fetal development. A deficiency can result in serious birth defects, such as spina bifida and anencephaly. This is why prenatal vitamins contain extra folate.

Healthy Folate Levels and What They Mean

Normal serum folate levels are above 2.5 ng/mL, with levels above 10 ng/mL considered elevated. Both low and high levels can have health implications.

Effects of Low Folate Levels

• Anemia: Folate is required for red blood cell production. A deficiency can lead to fatigue, weakness, and shortness of breath.
• Elevated homocysteine: Increased homocysteine levels can raise the risk of heart disease and stroke.
• Neural tube defects in pregnancy: A folate deficiency during early pregnancy can lead to serious birth defects affecting the brain and spine.

Effects of High Folate Levels

• While folate toxicity is rare, excess folate can mask a Vitamin B12 deficiency, leading to potential nerve damage if left untreated.