Folate deficiency

Folates are normally found in a wide variety of foods and are commonly consumed through a diet of green leafy vegetables, sprouts, fruits, brewer’s yeast, and animal products such as milk and dairy products, egg yolk and liver.

Where is folate found?

product		Average content (mcg/100g)
Baker’s yeast, dehydrated	2340
Liver chicken, raw	1640
Pollen, fresh	993
Nutritional yeast	697
Soya flour	573
Beans, mung, mature, seeds, dry	421
Wheat, whole, pre-cooked, raw	331
Basil, dried	310
Haricot bean, dry	307
Lentil, dried	257
Wakame, dried	237
Breakfast cereals, diet, plain	233
Chocolate powder for beverage, with sugar	219
Spinash, raw	207
Muesli	193
Quinoa	184
Egg yolk, cooked	166
Broccoli	153
Asparagus, green, raw	150
Brie cheese	140
Legume, cooked (average)	131

Folate and Folic Acid Content of Selected Foods – Reference: « Anses. 2020. Ciqual French food composition table ».

Unfortunately folates contained in foods are unstable and susceptible to oxidation; they rapidly lose activity during food processing, manufacturing and storage and have a bioavailability range of 25-50%, depending on the kind of food. Fresh leafy vegetables stored at room temperature may lose up to 70% of their folate activity within three days and a cooking process in water can increase the loss to 95%.

Humans cannot synthesize folate and because of its water-soluble nature, the body stores folate to a limited extent. For this reason folate represents a dietary requirement and must be consumed by diet. Whether we ingest food containing natural or synthetically derived folates, they are metabolized to 5-methyltetrahydrofolate, which is considered the biologically active form of the B-vitamin folic acid.

What happens if your folate is low?

Folate deficiency represents one of the most common nutritional deficiencies and may occur when dietary intake is inadequate when an increased need is not matched by an increased intake (particular physiological conditions such as pregnancy, lactation, child growth), when there is altered absorption/excretion (or losses) and when metabolism or drug use interferes with the ability of the body to use folate.

Who are the most at risk of folate deficiency? Several conditions can lead to nutritional folate deficiency such as enzyme defects, malabsorption, digestive system pathology, liver disease but also conditions with a high rate of cell turnovers such as rapid tissue growth (infants, kids, and adolescents) pregnancy, and lactation.

In severe cases, deficiency can cause many clinical abnormalities, including macrocytic anemia, cardiovascular diseases, and carcinogenesis. Folate deficiency is associated with elevated levels of homocysteine, cerebrovascular and neurological diseases, and mood disorders. In folate-deficiency anemia, the red blood cells are abnormally large. Such cells are called macrocytes. They are also called megaloblasts when they are seen in the bone marrow. That is why this anemia is also called megaloblastic anemia.

In pregnant women, the consequences of a folic acid deficiency are dramatic: anomalies in the development of maternal tissues (placenta, blood circulation) and fœtus (birth neural tube defects – NTDs – like spina bifida and anencephaly), delayed growth of the fœtus, an increase in the risk of premature births, low folate reserves in infants. From adolescence, the female population should thus ensure that its needs for folic acid are met.

What are the symptoms of folate deficiency? Deficiency of folate may be asymptomatic or present with symptoms of anemia, diarrhea, loss of appetite, and weight loss. Additional signs are weakness, sore tongue, headaches, heart palpitations, irritability, and behavioral disorders.

When should folate supplements be taken?

Clinical research emphasizes the importance of folate supplementation in:

Neural-tube defects (NTDs)
Male and female infertility
Spontaneous abortion
Coronary heart disease
Macrocytic anaemia
Methotrexate therapy
Epilepsy
Irritable bowel disease
Cognitive deficits in elderly
Lifestyle putting people at risk of low folate levels:

Smoking
Alcohol excess
Eating disorders
Low-vegetable intake
Chronic dieting

Folate and Healthful Diets

The federal government’s 2020–2025 Dietary Guidelines for Americans notes that “Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods. … In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients (e.g. during specific life stages such as pregnancy).” For more information about building a healthy dietary pattern, refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture’s MyPlate.

When to see a General Practitioner?

See a General Practionner if you think you may have a folate deficiency. This condition can often be diagnosed based on your symptoms and the results of a blood test. It’s important for folate deficiency (or vitamin B12) anaemia to be diagnosed and treated as soon as possible. This is because although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible.

How is Quatrefolic^® an Innovative Form of Nutrition?

Quatrefolic^®, the InnovActive Folate, provides the biologically active form of folate (the 5-MTHF) that the body can immediately use without any form of metabolization.