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Folate deficiency is rare in the U.S., but it does happen, and its signs are easy to mistake for other problems. Here are eight signs the NIH Office of Dietary Supplements lists, plus who’s most at risk and what to do if you notice them.
Why low folate causes symptoms
Your body needs folate to make DNA and healthy red blood cells. Without enough, your body can make red blood cells that are too large and don’t work well. This is called megaloblastic anemia, and it’s the main sign of folate deficiency, according to the NIH. Low vitamin B12 causes the same kind of anemia. For more, see Folic Acid and Anemia.The 8 signs
The first five come from the anemia itself. The rest are other changes the NIH links to low folate.- Tiredness and weakness. Feeling worn out even after rest.
- Shortness of breath. Getting winded more easily than usual.
- A fast or pounding heartbeat. Also called heart palpitations.
- Headaches.
- Trouble concentrating or feeling irritable.
- A sore tongue or mouth sores. Soreness and shallow sores on the tongue and inside the mouth.
- Changes in skin, hair, or nail color.
- Stomach or digestive problems.
Who’s most at risk
The NIH says folate deficiency usually happens alongside other nutrient problems, and that these groups are more likely to run low:- People who drink heavily. Alcohol makes it harder to absorb and keep folate.
- Women who could become pregnant. Some don’t get enough, even with supplements.
- Pregnant women. The body needs more folate during pregnancy.
- People with conditions that affect absorption, such as celiac disease or inflammatory bowel disease.
- People with an MTHFR gene variant, which makes it harder to convert folate to its active form.
