What Is Folic Acid Deficiency Anemia?

Having too little folate (vitamin B9) in your blood causes folic acid deficiency anemia.

Folate is necessary for your body to make new red blood cells. Your body needs red blood cells to carry oxygen to your organs. Not having enough red blood cells causes a condition called anemia, which can make you feel weak and tired.

Your baby may be at higher risk of developing serious birth defects like spina bifida if you have folic acid deficiency anemia during pregnancy. Spina bifida causes the baby’s spinal column to be malformed.

If you’re folic acid deficient, taking supplements to increase your folic acid level can reduce your risk of developing anemia. What’s more: Experts at Harvard Medical School say that getting enough folic acid can reduce your risk of developing colon cancer and heart disease.

Folic acid is the synthetic version of the vitamin folate, also called B9. Your body loses B9 when you sweat and urinate. And your body can’t store it, so you need this vitamin daily.

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

Factors that increase your likelihood of developing this condition include:

  • eating overcooked foods
  • consuming a vitamin-poor diet
  • heavy alcohol drinking (alcohol interferes with folate absorption)
  • medical conditions (like sickle cell disease)
  • medications
  • pregnancy

Malnutrition is the most common cause of folic acid deficiency anemia. Eating a diet low in vitamins or overcooking foods can contribute to malnutrition. Heavy bleeding can also lead to anemia.

Foods rich in folic acid include citrus fruits, leafy green vegetables, and fortified cereals. Some people have trouble absorbing folic acid from food.

Other causes of folic acid deficiency anemia include the following.


Pregnancy causes folic acid deficiency for several reasons. Your body is slower to absorb folic acid during pregnancy, and the fetus consumes your body’s folic acid as it grows. Morning sickness that results in vomiting can cause you to lose folic acid.


Malabsorption occurs when your body can’t properly absorb a vitamin or mineral. Diseases such as celiac disease and medications, including those to control seizures, can disrupt the way your body absorbs folic acid.

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

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

Be sure to mention to your doctor whether you’re taking any medications. Some can contribute to folic acid deficiency.

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, you might need to receive folic acid intravenously if your levels are too low.

Along with taking supplements, you should eat foods that are high in folic acid, such as pinto beans, spinach, and oranges. Eat plenty of fresh foods and avoid processed or fried foods. They’re 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.

Consult with your doctor before taking folic acid supplements.

After treatment, most people with folic acid deficiency recover from this condition with no long-term health effects.