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Folate Deficiency vs B12 Deficiency – A Basic Guide

Folate Deficiency vs B12 Deficiency

Folate is a natural source of the B vitamin B9 found in food. Folic acid, on the other hand, is a synthesized form of folate that is present in supplements and fortified foods. Folic acid has a higher bioavailability than organic folate.

The adult body stores about 1000 to 20000 mcg of folate, which is why an adult needs about 400 mcg daily to replenish the potential loss.

Folic acid is a B9 vitamin that helps the body with making red blood cells. Folate is a water-soluble vitamin that is organically present in food, including liver, green veggies, and fruits. Folate deficiency can cause anemia, which is a condition where one might have too few RBCs.

Anemia can deprive the tissues of oxygen because the red blood cells in the body carry the oxygen, which can then affect their function.

What Deficiencies Does Folate Deficiency Cause?

Folate deficiency can cause macrocytic anemia, which is a condition that refers to the aspect where the body has overly large red blood cells but not enough normal red blood cells. Often. Macrocytic anemia is caused by a lack of folate and vitamin B-12.

Usually, folate depletes rapidly within four to five months, which makes it the most common cause of macrocytic anemia. On the other hand, vitamin B12 takes four to five years to deplete.  

Folate deficiency is also linked with megaloblastic anemia, where the RBCs are not fully developed and are are larger than normal. Despite the fact that this deficiency is similar to vitamin B12 deficiency, it doesn’t cause neurological symptoms, while vitamin B12 deficiency does.

Most of the time, B12 deficiency will cause neurological deficits. However, folate deficiency won’t cause a neurological deficit.

Potential Symptoms of Folate Deficiency & B12 Deficiency

Here are several symptoms of folate deficiency:

  • Lack of energy
  • Extreme fatigue
  • Paraesthesia (pins and needles)
  • Sore tongue
  • Red tongue
  • Mouth sores
  • Gray hair
  • Reduced sense of taste
  • Diarrhea

It is important to mention here that folic acid or B12 deficiency can present very similar symptoms and many times, these symptoms can occur simultaneously. However, the symptoms of folic acid deficiency are more of a neurological nature.

Here are several signs of vitamin B12 deficiency:

  • Changes in movement/ walking
  • Irritability
  • Disturbed vision
  • Depression
  • Changes in the way you think/ feel/ behave
  • A decline in mental abilities, including understanding, memory, and judgment

Potential Sources of Folate

Referring to some good sources of folate, you can find folate in broccoli, Brussels sprouts, and leafy green veggies, such as spinach, spring greens, cabbage, and kale.

You can also get folate from peas and liver. However, some doctors recommend that women avoid consuming liver during pregnancy and opt for supplements instead, such as gummy prenatal vitamins that are made of 21 vegetarian ingredients. Typically, breakfast cereals are also fortified with folic acid and serve as a potent source of folate.

A diet that is low in fortified cereals, vegetables, and fruits can cause folate deficiency as well. Also, overcooking meals can destroy the vitamins as well. A folate deficiency is also common amongst the elderly who subsist on a regular diet of tea and toast.

An unhealthy diet often manifests itself in the body in the form of hyponatremia, which is a low concentration of electrolyte sodium in the bloodstream caused by a lack of salt in one’s daily diet.

Who is at Risk?

Now, the question is that certain vulnerable groups of people are prone to develop a folate deficiency. For instance, people who consume alcohol can suffer from a deficiency in B12 and B9. People with gastrointestinal issues, such as Crohn’s disease and ulcerative colitis, can suffer from a folate deficiency or are anemic.

Also, pregnant women can have a folate deficiency. Cancer patients can have folate deficiency as well.

Sometimes, medications can cause folate deficiency as well. This mainly happens because certain medications can impair the absorption or inhibit the physiologic effects of folate. Some of these medications include the following:

  • Bactrim – An antibiotic
  • Phenytoin
  • Methotrexate
  • Azulfidine

It is essential for folate deficiency anemia or vitamin B12 anemia to be diagnosed and treated as soon as possible. Despite the fact that many symptoms of B12 anemia and folate deficiency anemia can be improved with treatment, some health problems caused by the condition can become irreversible if they are left untreated.

The longer the illness remains untreated, the higher the risk of permanent damage. Typically, the treatment involves increasing one’s dietary intake of folate or folic acid supplements. If you are pregnant, you should fully avoid alcohol; however, the same rule applies to everyone else with a folate deficiency.

Also, before you start taking folic acid supplements for anemia, you should fully rule out the deficiency of vitamin B12. If you mistakenly treat vitamin B12 deficiency with folate, neurological deficits can be precipitated or get worse with time.


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