Folic Acid Deficiency Anemia

Written by April Khan | Published on July 25, 2012
Medically Reviewed by Sylvia S. Hanna, MD

What is Folic Acid Deficiency Anemia?

Folic acid deficiency anemia is caused by having too little vitamin B9 (folate) in your blood.

Folate is necessary for your body to make new red blood cells. Red blood cells are needed to carry oxygen to your organs. If you do not have enough red blood cells, you have anemia, which can make you feel weak and tired.

If you have folic acid deficiency anemia during pregnancy, your baby may be at a higher risk of developing serious birth defects, such as spina bifida. Spina bifida causes the baby’s spinal column to be malformed.

If you are folic acid deficient, taking supplements to increase your folic acid level can reduce your risk of developing anemia.

According to experts at Harvard Medical School, getting enough folic acid can reduce your risk of developing colon cancer and heart disease. (Harvard)

What Is Folic Acid?

Folic acid is the synthetic version of the vitamin folate, also called B9. This vitamin is lost when you sweat and urinate. Vitamin B9 is not stored in your body, so it has to be replaced daily.

What Causes Folic Acid Deficiency Anemia?

The most common cause of folic acid deficiency anemia is malnutrition. Consuming a diet low in vitamins or overcooking foods can contribute to malnutrition. Foods rich in folic acid include citrus fruits, leafy green vegetables, and fortified cereals. Some people have trouble absorbing folic acid from food. Bleeding heavily can also lead to anemia.

Other causes of folic-acid deficiency anemia are:


During pregnancy, your body is slower to absorb folic acid. The fetus also consumes your body’s folic acid as it grows. Morning sickness that results in vomiting can also cause you to lose folic acid.


Malabsorption occurs when a vitamin or mineral cannot be absorbed into your body properly. Certain diseases and medications can disrupt the way folic acid is absorbed, including celiac disease and medications to control seizures.

Who Is At Risk For Folic Acid Deficiency Anemia?

Certain factors increase your likelihood of developing this condition, including:

  • eating overcooked foods
  • consuming a vitamin-poor diet
  • heavy alcohol drinking (alcohol interferes with the absorption of folate)
  • medical conditions (such as sickle cell disease)
  • medications (i.e., medications for cancer, rheumatoid arthritis or seizures)
  • pregnancy

Signs and Symptoms

Symptoms of folic acid deficiency include:

  • fatigue
  • mouth sores
  • gray hair
  • swollen tongue
  • poor growth (also among the chief symptoms of malnutrition)

Once anemia occurs, you might experience the following:

  • fatigue
  • dizziness
  • feeling cold
  • irritability
  • headache
  • difficulty breathing
  • pale skin
  • diarrhea
  • weight loss
  • loss of appetite
  • difficulty concentrating

How Is Folic Acid Deficiency Anemia Diagnosed?

Since other blood conditions cause symptoms similar to folic acid deficiency anemia, you’ll need to see your doctor for a diagnosis. To determine if you have folic acid deficiency anemia, your doctor will do a complete blood count (CBC) test. This test will reveal if your red blood cell count is low.

Your doctor may also order a blood test to check your folic acid levels. This is called a red blood cell folate level test. If you are of childbearing age, your doctor may order a pregnancy test to determine if this is the cause of your deficiency. He or she will also ask questions about your eating habits to see if malnutrition is the culprit.

If you are taking any medications, be sure to mention them to your doctor, since some medications can contribute to folic acid deficiency.

How Is Folic Acid Deficiency Anemia Treated?

The goal of treatment is to increase your body’s folic acid levels. The easiest way is to take folic acid tablets daily, until the deficiency is corrected. However, if your levels are too low, you might need to receive folic acid intravenously.

Along with taking supplements, you should consume foods that are high in folic acid, such as pinto beans, spinach greens, and oranges. Eat plenty of fresh foods and avoid processed or fried foods because they are usually low in nutrients and high in fat.

Harvard Medical School guidelines recommend consuming 400 mcg (micrograms) of folic acid per day. Pregnancy and certain health conditions may warrant taking more. The most you can take without developing symptoms of an overdose is 1,000 mcg of folic acid per day. (Harvard)

Consult with your doctor before taking folic acid supplements.

What Is My Long-Term Outlook?

After treatment, most patients with folic acid deficiency improve dramatically. Patients usually recover from this condition with no long-term health effects.

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