Folate (vitamin B11) is needed for cell division and the production of red blood cells. A deficiency can cause fatigue, anaemia and mouth complaints, and matters most around pregnancy. This article is part of our overview of vitamin deficiency. Below you read the symptoms, who is at risk and how to test for it.
What is folate?
Folic acid is the synthetic form of folate, a B vitamin (B11, also called B9). Your body uses it to make DNA, for cell division and for the formation of red blood cells. You get folate from food and folic acid from supplements and fortified products.
Symptoms of a folate deficiency
A folate deficiency resembles a vitamin B12 deficiency in its symptoms, because both are needed for blood formation. Common complaints are fatigue, a pale skin and shortness of breath from anaemia.
- Fatigue and weakness
- Pale skin and shortness of breath - from anaemia (megaloblastic anaemia)
- Mouth ulcers and a red, smooth tongue
- Irritability and concentration problems
Because the complaints resemble those of a vitamin B12 deficiency, folate and B12 are often assessed together.
Folate and pregnancy
Folate matters most around pregnancy. The Netherlands Nutrition Centre advises women trying to conceive to take 400 micrograms of folic acid a day, from the moment you want to become pregnant until 10 weeks into pregnancy. Extra folic acid in this period lowers the risk of spina bifida in the baby.
This advice also applies if your folate value is normal. It is a preventive measure, not a treatment of a deficiency.
Where is folate found?
- Green leafy vegetables: spinach, kale, lettuce
- Legumes: lentils, chickpeas, beans
- Citrus fruit and wholegrain products
- Fortified products: some breakfast cereals
Folate from food is sensitive to heat, prolonged cooking can lose part of it. Raw or briefly cooked vegetables retain more folate.
Who is at risk of a folate deficiency?
- Women trying to conceive or pregnant - increased need
- People with a one-sided diet - little vegetables and legumes
- People with gut conditions - coeliac disease, Crohn's
- People who drink a lot of alcohol - alcohol inhibits absorption
- Users of certain medicines - some affect folate metabolism
Testing for a folate deficiency
A blood test measures your folate value. Because a folate deficiency and a B12 deficiency resemble and can mask each other, they are often measured together. Want to check both? Build a custom blood test.
Frequently asked questions
What is the difference between folic acid and folate?
Folate is the natural form in food, folic acid the synthetic form in supplements and fortified products. Folic acid is absorbed slightly better, which makes it handy around pregnancy.
Can I get too much folic acid?
Not through food. Through supplements there is an upper limit of 1 milligram a day. A high intake can mask a vitamin B12 deficiency, so coordinating with your doctor is wise.
Every blood test result at Vitalcheck includes a professional assessment by a BIG-registered doctor. A blood value is not a diagnosis: always discuss symptoms and treatment decisions with your GP.
References
- Netherlands Nutrition Centre. Folic acid and pregnancy. Accessed 2026.
- RIVM. Folic acid around pregnancy, data in the Netherlands. 2019.
- Health Council of the Netherlands. Dietary reference values for vitamins and minerals. 2018.
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