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Folate (Vitamin B9)

What is folate?

B vitamins help your body perform a variety of functions, including energy metabolism, creating blood cells, and maintaining brain function. Vitamin B9, also called folate and folic acid, contributes to cell growth and the production of DNA and red blood cells. Lack of folate may cause anemia, one of the symptoms of which is fatigue. Folate is especially important for healthy fetal development.

Who is at risk of having low folate levels?

Those at risk for not getting enough B vitamins in their diet include the elderly who have a poor diet, alcoholics, those with digestive disorders that prevent nutrient absorption, and pregnant women.

When should I test for folate?

This test is advisable if you’re experiencing symptoms of anemia that may be caused by a folate deficiency, which include extreme fatigue, shortness of breath, pale skin, heart palpitations, mental confusion, and more. Since some forms of anemia can be caused by a vitamin B12 deficiency³, it might be advisable to also test levels of this vitamin. Measurement of both of these biomarkers is needed to determine the cause.

People who are planning to get, or are, pregnant should test their folate levels as supplements can prevent neural tube birth defects and may prevent spontaneous abortions²

What is a normal folate level?

Folate levels in blood greater than 4.0 µg/L are considered normal¹

What is a low level of folate?

Folate levels lower than 4.0 µg/L suggest folate deficiency¹.

What does a low level of folate mean?

As approximately 20% of folate comes from the food you eat, low levels are usually due to a lack of folate in the diet. Folate deficiency is most common in pregnant people and alcoholics¹, has been found in patients with psychiatric disorders¹, and is a risk factor for spontaneous abortions².

How can I improve my folate levels?

Most people can get the folate they need from food. You can improve your folate levels by eating food rich in folate, including dark green leafy vegetables, beans, peas, and nuts. It is also found in citrus fruits, bananas, melons, and strawberries. It is recommended that people who plan to get pregnant or are pregnant or breastfeeding take a folic acid supplement.


  1. de Benoist B. Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. Food Nutr Bull 2008;29(2 Suppl):S238–244.
  2. George L, Mills JL, Johansson AL, et al. Plasma folate levels and risk of spontaneous abortion. JAMA 2002;288(15):1867–1873.
  3. Nagao T, Hirokawa M. Diagnosis and treatment of macrocytic anemias in adults. J Gen Fam Med 2017;18(5):200–204.
  4. Mayo Clinic. Vitamin deficiency anemia. Available from: https://www.mayoclinic.org/diseases-conditions/vitamin-deficiency-anemia/symptoms-causes/syc-20355025
Last updated:
September 23, 2021

Test for folate (vitamin B9)

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