Vitamin B9 (Folate)

Optimal Result: 3 - 20 ng/mL, or 6.80 - 45.32 nmol/L.

Folate is one of many B vitamins needed by our bodies. Folate is used to make red blood cells, white blood cells, platelets, and for normal cell growth. Folate also plays an important role in the development of a healthy fetus. Folate cannot be made by the body and must be ingested through foods like citrus fruits, dark greens, leafy vegetables, whole grains, beans, cereals enriched with B vitamins, kidney, and liver. 

A healthcare professional may order a Folate test to:

- Check for the cause of anemia (low red blood cell count)

- Check for malnutrition or absorption problems  (i.e., celiac disease, inflammatory bowel disease)

- Monitor treatment for folate deficiency

- Assure a pregnant woman has enough folic acid to prevent birth defects

Without enough Folate in your body, a developing baby’s neural tube may not close correctly, and they could develop a neural tube defect. These include:

- Spina bifida: incomplete development of the spinal cord or vertebrae

- Anencephaly: incomplete development of major parts of the brain

These defects can occur within the first 3-4 weeks of pregnancy. So it’s important for expecting mothers to have enough folate (400 micrograms / day) during those early stages when the baby’s brain and spinal cord are developing. 

What's the difference between Folate and Folic acid?

Folate is the natural form of vitamin B9 in food, while folic acid is a synthetic form.

- The terms “Folic acid” and “Folate” often are used interchangeably. However, folate is a general term used to describe the many different forms of vitamin B9: folic acid, dihydrofolate (DHF), tetrahydrofolate (THF), 5, 10-methylenetetrahydrofolate (5, 10-MTHF), and 5-methyltetrahydrofolate (5-MTHF).
- Folic acid is the synthetic (that is, not generally occurring naturally) form of folate that is used in supplements and in fortified foods, such as rice, pasta, bread, and some breakfast cereals. In many scientific studies done in countries around the world, folic acid has been shown to be effective in preventing neural tube defects.
- Natural folate can be found in foods such as leafy green vegetables, citrus fruits, and beans. A woman should eat a balanced diet rich in natural folate from food. However, it is very difficult for most women to get the daily recommended amount of folate through food alone.
- Supplements containing forms of folate other than folic acid (such as 5-MTHF) should not be confused with the natural food folate found in fruits and vegetables. The effectiveness of these supplements in preventing neural tube defects has not been studied.

What does it mean if your Vitamin B9 (Folate) result is too low?

A low Folate level may mean you have a problem with your diet, alcohol dependence, or an eating disorder such as anorexia nervosa. It may also mean you have a problem absorbing or using Folate, such as: vitamin C deficiency, liver disease, celiac disease, or Crohn’s disease. Signs and symptom of folate deficiency include:

- Diarrhea

- Dizziness

- Fatigue

- Loss of appetite

- Rapid or irregular heart rate

- Confusion

- Paranoia 

What does it mean if your Vitamin B9 (Folate) result is too high?

A high level of Folate in the blood may indicate that you eat a diet rich in folic acid or are taking folate supplements. Folate is a water-soluble vitamin, and as such the body can easily remove excess amounts through urine. Therefore, consuming more Folate than the body needs does not cause problems. A high Folate level can also mean vitamin B12 deficiency. Our bodies need vitamin B12 to use Folate; if there isn’t enough vitamin B12 then a buildup of folate can occur. That being said, a folic acid test isn’t a reliable way to test for vitamin B12 deficiency. 

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