Folate (Folic Acid) Effects, Pregnancy, Deficiency Symptoms, Dose

Folate (vitamin B9) is one of the B-complex of vitamins that is derived from a number of foods. It is probably best known for being an important part of pregnancy and pregnant women are always advised to use folic acid supplements. There is often confusion between folate and folic acid. Simply folate is the vitamin B9 absorbed from natural sources like food whereas folic acid is the synthetic form derived from supplements.

Effects of Folate

Folate is one of the important vitamins that play an integral role in protein synthesis. Since protein is the structural framework of every cell of the body, even down to the genetic blueprint (DNA), its production and layout has to be flawless. Folate assists in these processes and therefore a lack of this vitamin will lead to structural defects and deformities. The replication of cells can even be inhibited by a folate deficiency.

Sources of Folate

Folate is available from a large number of sources, both plant and animal. Some of the foods that are high in folate include :

  • Citrus fruits like lemons and oranges
  • Avocado
  • Asparagus
  • Brocolli
  • Leafy green vegetables like spinach
  • Peas
  • Tomatoes
  • Meat, particularly offals
  • Eggs
  • Rice
  • Beans
  • Wheat germ

Folate Deficiency and Symptoms

Folate is sourced primarily from food and absorbed in the gut (small intestine). A deficiency may arise with malnutrition, strict dieting and fasting, intestinal diseases that compromise folate absorption and certain drugs that break down folate. Excessive alcohol consumption and overcooking folate-rich foods may also be contributing factors to a deficiency.

One of the effects of a folate deficiency is an abnormality in new red blood cells. This is known as megaloblastic anaemia where the red blood cells are too large, vary in shape and are fragile. These cells are quickly damaged and destroyed thereby leading to a deficiency of red blood cells known as anaemia. In pregnancy, the effects of a folate deficiency on the developing baby can lead to serious deformities.

Symptoms of  folate deficiency include fatigue, mouth pain and mouth sores, smooth swollen tongue, grey hair, diarrhoea and headaches. Patients may also complain of breathlessness, palpitations and mood swings.

Folic Acid and Pregancy

Pregnant women are always advised to take folic acid supplements even if they are eating well and do not have a folate deficiency. The growing foetus places demands on the mother’s resources and can quickly lead to a deficiency. If there is a lack of folate available for the growing baby, a type of deformity known as spina bifida can occur. Although governments around the world have taken measures to fortify foods with supplements like folic acid, an inexpensive supplement should be used throughout pregnancy.

Spina bifida is a neural tube defect where there is a disturbance in the closure of the vertebral column. The exact cause of this defect is unknown but a low folate intake is a risk factor. Spina bifida may be detected through blood tests done on the pregnant mother or by testing the amniotic fluid. Surgery may be required to repair this defect once the baby is born.

Folic Acid Doses

The dosage of folic acid varies depending on the age of the person. Children are typically prescribed less than 400mcg (micrograms) per day while infants less than 1 year old should use less than 100mcg/day. Teens and adults may use up to 400mcg/day. Breastfeeding women should look at doses of 500mcg/day and pregnant women are advised to take higher doses of approximately 600 mcg/day. Excessive folic acid supplementation may lead to side effects such as nausea, bloating, skin rashes, breathing difficulties and malaise.