Folate, which is a B vitamin, naturally occurs in a variety of foods. Foods such as leafy greens, citrus fruits, beans, nuts, peas, eggs, seafood, dairy products, meat, poultry, and grains are rich sources of folate. Pregnant women particularly benefit from folate as it supports the growth and development of the foetus and aids in the prevention of birth defects.

What is folic acid?

Folic acid is a synthetic version of folate, which is naturally occurring. Unlike natural folate, your body cannot store significant amounts of it. However, folic acid is easily absorbed by your body and is therefore added to certain foods. Enriched grains like rice, bread, pasta, and some cereals are fortified with folic acid. Additionally, folic acid is available in the form of a dietary supplement.

Anaemia and Vitamin B12 deficiency

Vitamin B12 is a crucial nutrient required by your body to support various functions, including DNA synthesis, energy production, and the proper functioning of the central nervous system.
Anaemia caused by a deficiency of vitamin B12 or B9, also known as folate, occurs when the body fails to produce properly functioning red blood cells due to insufficient amounts of these vitamins. The primary role of red blood cells is to transport oxygen throughout the body using a substance called haemoglobin.

Anaemia is a broad term that encompasses a condition where an individual has either a lower-than-normal count of red blood cells or an unusually low level of haemoglobin in each red blood cell.

There exist various types of anaemia, each with its distinct cause. For instance, iron deficiency anaemia arises when the body lacks an adequate amount of iron.

Symptoms of folate deficiency

Fatigue, characterised by excessive tiredness, is often among the primary symptoms. Additionally, other symptoms may include such as:

1. Symptoms resembling anaemia
2. Paleness
3. Breathing difficulties (dyspnea)
4. Irritability
5. Dizziness

Oral symptoms of folate deficiency:

1. Sore and inflamed tongue (tender, red tongue)
2. Presence of mouth sores or ulcers
3. Decreased or altered sense of taste

Neurological symptoms

1. Impaired memory
2. Difficulty focusing or concentrating
3. Confusion
4. Impaired judgement

Causes of folate deficiency

Folate deficiency often arises from inadequate consumption of a well-rounded, nutritious diet. A healthy eating regimen should incorporate foods naturally rich in folate or fortified with folic acid. Additionally, there are other factors that can contribute to folate deficiency, such as:

1. Conditions like Crohn's disease or celiac disease can impede the absorption of folic acid in the digestive system.
2. People  who consume excessive amounts of alcohol may prioritise alcohol over food, resulting in insufficient folate intake.
3. If you cook them for too long, the heat can deplete the naturally present folate in your produce.
4. Hemolytic anaemia, a blood condition where your red blood cells are destroyed and cannot be replenished quickly enough.
5. The absorption of folate can be impaired by specific medications such as anti-seizure drugs and those prescribed for ulcerative colitis.
6. Renal dialysis provided to people with kidney failure.

Diagnosis

Folate deficiency anaemia cannot be diagnosed solely based on its symptoms. There are various types of anaemia, such as those caused by low iron or vitamin B-12 levels, which can present similar symptoms.

Typically, a blood test is necessary for doctors to diagnose folate deficiency anaemia. By measuring the concentration of folate in the blood, it becomes possible to determine if the person has adequate folate levels in their body.

In the case of folate deficiency anaemia, a blood test may also reveal the presence of abnormally shaped and immature blood cells known as megaloblasts. These oversized and inefficient red blood cells cannot effectively deliver oxygen to the body. If megaloblasts are detected in the blood test, it strongly suggests that the individual is deficient in either folate or vitamin B-12.

Prevention

To prevent folate deficiency, it is recommended to maintain a balanced diet that incorporates foods rich in folate or folic acid. Natural sources of folate include:

1. Legumes such as peas, beans, and lentils
2. Citrus fruits
3. Dark green leafy vegetables
4. Organ meats like liver
5. Seafood
6. Eggs and dairy products
7. Meat and poultry

Conclusion

A deficiency in vitamin B12 can lead to various symptoms such as tiredness, migraines, low mood, paleness or yellowing of the skin, cognitive decline, and discomfort and swelling in the mouth and tongue. The symptoms associated with low levels of vitamin B12 are not exclusively indicative of B12 deficiency, making it difficult to identify the condition.

If you are encountering any of the aforementioned symptoms, it is crucial to seek medical attention from a healthcare professional in order to undergo proper testing and receive suitable treatment.