Folate, Serum

B12 and folic acid blood testing help doctors diagnose central nervous system disorders, anemia, and malabsorption syndromes. B12 and folic acid also play an important role in energy level, muscle strength, and memory. Because B12 and folate are derived solely from dietary intake, such as egg yolks, beef, poultry and fish, many people are deficient in these important vitamins. Fasting for 8 to 12 hours is required for this test. Make sure you drink water in order to stay hydrated. A B12 test must be ordered in addition to folate.

What is Folate?

Folate is a water-soluble vitamin that is vital for human growth and the formation of red and white blood cells. Otherwise referred to as Vitamin B-9, folate is a particularly crucial nutrient for pregnant women as it can prevent fetal birth defects of the brain and spine. Folate is used in synthesizing DNA and RNA and plays a crucial role in breaking down amino acids.

Why Should I Test My Folate Levels?

Mild folate deficiency does not usually cause symptoms. However, a severe lack of folate can cause:

• Extreme fatigue
• Numbness/tingling in the hands and feet
• Soreness and redness of the tongue
• Mouth ulcers
• Vision disturbances
• Psychological problems such as depression

Low levels of folate can also be a precursor for megaloblastic anemia, characterized by very large, underdeveloped red blood cells (megaloblasts). This malformation prevents an individual’s bone marrow from creating as many cells as possible, hich can result in headaches, tinnitus, or heart palpitations. Folate, Serum is a test designed to measure folate levels in the liquid part of the blood, or plasma. This information helps doctors diagnose anemia, malabsorption syndromes, and central nervous system disorders. Folate is crucial in preventing these conditions and promotes healthy cell growth and function.

Where Do I Get Folate?

Folate is derived exclusively from dietary intake, causing many people to be deficient in vitamin B-9. Naturally occurring folate can be found in foods such as leafy green vegetables (spinach, kale, broccoli), Citrus fruits, liver, and lentils. Many grain products, such as cereals and bread, are fortified with folic acid, a synthetic form of vitamin B-9. Due to the entanglement between diet and vitamin B-9, folic acid absorption can be blocked by diseases that affect the digestive system such as celiac or Crohn’s disease. Absorption can also be limited by drinking too much alcohol or overcooking vegetables, as folate can be quickly denatured by heat. Folic acid can also be taken as a supplement in capsule form, for anyone who may be experiencing a folate deficiency, most critically, pregnant women. This deficiency can be impacted by several factors including:

• Poor nutrition
• High alcohol consumption
• Smoking
• Chemotherapy
• Kidney dialysis
• Pregnancy
• Advanced age

Can I Have Too Much Folate?

A normal range of folate in the bloodstream is between 3 and 17 nanograms per milliliter (ng/mL). Observational studies have indicated that high folate levels may possess chemopreventive characteristics against cancer and cardiovascular diseases. Since folate is soluble in water, excess B-9 is typically dispelled from the body over time through one’s urine. A surplus of folate is very rarely harmful to the body; however, it can indicate a deficiency in B-12, the vitamin responsible for putting folate to use. Due to their intertwined functionality, B-9 tests like Folate, Serum additionally require patients to order a B-12 test. Even if an individual has ample folate in their blood, a deficiency in Vitamin B-12 can still result in megaloblastic anemia. Without this crucial B vitamin, folate sits idle in the bloodstream, unable to synthesize DNA, resulting in megaloblasts, large red blood cells that cannot efficiently carry oxygen to organs and tissue throughout the body.

What to Know About Folate Testing

Folate testing is commonly performed to follow up on abnormal blood tests or if a patient is experiencing symptoms of folate deficiency. The test is performed on a sample of blood drawn in a professional medical setting, such as a doctor’s office, health clinic, or lab. The process of drawing blood takes only a few minutes. The patient must fast for up to eight hours before the test, as folate levels can be impacted based on recently consumed foods. Neglecting to fast or improper fasting can result in false elevation of folate levels. You should also check with your healthcare provider to see if any medications you are prescribed could interact with the test. This is the case for many common drugs, such as birth control pills, estrogen, folic acid supplements, and anti-seizure medications. It is imperative during pregnancy to maintain a surplus of folate to allow the fetus to grow and develop healthily. Doing so will minimize the risk of birth defects in the neural tube.

Sources

Allen, L. H. (2008). Causes of vitamin B12 and folate deficiency. Food and nutrition bulletin, 29(2_suppl1), S20-S34.

Eichholzer, M., Tönz, O., & Zimmermann, R. (2006). Folic acid: a public-health challenge. The Lancet, 367(9519), 1352-1361.

Green, R., & Miller, J. W. (1999, January). Folate deficiency beyond megaloblastic anemia: hyperhomocysteinemia and other manifestations of dysfunctional folate status. In Seminars in hematology (Vol. 36, No. 1, pp. 47-64). [Sheboygan, Wis.]: Grune & Stratton,[c1964-.

Kamen, B. (1997, October). Folate and antifolate pharmacology. In Seminars in oncology (Vol. 24, No. 5 Suppl 18, pp. S18-30).

Eichholzer, M., Tönz, O., & Zimmermann, R. (2006). Folic acid: a public-health challenge. The Lancet, 367(9519), 1352-1361.

Tamura, T., & Picciano, M. F. (2006). Folate and human reproduction. The American journal of clinical nutrition, 83(5), 993-1016.

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