Folate, also known as vitamin B9, is a water-soluble vitamin that is essential for the body to function properly. It plays a crucial role in:

• The production and repair of DNA and RNA : Necessary for cell growth and repair.
• The metabolism of amino acids : Essential for the proper functioning of cells.
• The formation of red and white blood cells : Supports the production of blood cells in the bone marrow.
• The conversion of carbohydrates into energy : Provides energy to cells.

For pregnant women, folate is vital for healthy fetal development, including the prevention of neural tube defects.

Since the body cannot produce folate, it must be supplied through food or supplements. Folate deficiency can lead to health problems, such as certain types of anemia and complications during pregnancy.

A folate test is generally recommended to check for a possible deficiency or to monitor certain disorders. It helps diagnose the underlying causes of various symptoms and imbalances related to folate.

Your doctor may recommend a folate test in the following cases:

• Diagnosis of anemia : To distinguish types of anemia, especially megaloblastic anemia.
• Pregnancy planning : To ensure that folate levels are sufficient for fetal development.
• Nutritional deficiencies : In people with an unbalanced or restrictive diet.
• Gastrointestinal disorders : To assess folate absorption under conditions affecting the digestive system.
• Treatment follow-up : In patients receiving treatments that may affect folate levels.
• Tiredness or weakness : These symptoms may indicate folate deficiency.

Folate levels are mostly measured by a blood test. A venous blood sample is taken to assess the amount of folate in serum or red blood cells.

In some cases, folate levels can also be measured in the urine, but blood tests are still the most common.

Types of tests that measure folate:

• Serum folate test : Measures the amount of folate circulating in the blood at the time of the test.

Preparations for the test:

• An 8-hour fast is often required to get accurate results.
• Avoid taking supplements or medications that contain folate a few days before the test, as this may affect the results.

In adults, normal folate levels are generally between 12.46 and 61.18 nmol/L.

Note : The units of measurement and the normal ranges may vary depending on the laboratory and the methods used.

High folate levels
High folate levels are generally less common.

Causes of high levels:

• Excessive food intake : High consumption of foods fortified with folic acid or supplements.
• Metabolic disorders : Some conditions affecting folate metabolism can cause increased levels.
• Specific vegetarian diets : A diet rich in vegetables that contain folate, without adequate protein intake, can lead to high levels.

Recommendations:

• Talk to a health professional about your diet to adjust your folate intake if needed.
• Avoid taking unnecessary supplements unless prescribed by a doctor.
• Watch your overall health, as high levels may indicate other issues that need attention.

Low folate levels
Low folate levels are more common and can cause complications such as anemia or pregnancy-related problems.

Causes of low levels:

• Pregnancy : An increased demand for folate can lead to a deficiency if it is not compensated by supplements.
• Excessive alcohol consumption : Alcohol interferes with the absorption and storage of folate.
• Poor diet : A lack of folate-rich foods, such as green leafy vegetables, can lead to a deficiency.
• Gastrointestinal diseases : Conditions such as Crohn's disease or celiac disease alter the absorption of folate.
• Liver or kidney diseases : These conditions can affect the body's ability to process and store folate.

Recommendations:

• Increase your food intake : Eat more green leafy vegetables, legumes, and citrus fruits.
• Reduce or eliminate alcohol : Alcohol can contribute to folate deficiency.
• Take supplements if needed : Consult a doctor to find out if folate supplements are recommended.
• Treat underlying conditions : Work with a health professional to treat conditions that could cause folate deficiency.

If you have concerns about your folate levels or associated health conditions, consider seeing the following specialists:

• General practitioner : For general concerns and initial testing.
• Gastroenterologist : In case of gastrointestinal disorders affecting the absorption of folate.
• Nutritionist : For advice on dietary changes and proper nutrition.
• Hematologist : If anemia or blood disorders are suspected.
• Gynecologist : For concerns related to pregnancy and folate.
• Pediatrician : If a child shows signs of folate deficiency.