Patient Guide
Understanding Low Folate
Vitamin B9 — what it does, why it drops, and how we put it right
Vitamin B9the other name for folate
Blood & DNAneeded to build both
Treatabletablets and food restore it
Low folate is common — and simple to put right. Folate — vitamin B9 — helps your body build healthy red blood cells and make new DNA. When it runs low you can feel tired and run-down, much like low iron or B12. The good news: it's usually easy to diagnose and to treat.
Why might my folate be low?
Not enough in your diet
Folate comes mainly from greens, beans, citrus and wholegrains. Low intake is the commonest cause.
More likely if: few vegetables, or lots of processed food.
Your body needs more
Pregnancy and breastfeeding sharply increase how much folate you need.
Pregnant or planning? Folic acid is especially important.
Trouble absorbing it
Coeliac disease and other gut conditions can stop folate being taken in properly.
More likely if: tummy symptoms or a known gut condition.
Alcohol
Regular drinking lowers folate — it reduces absorption and speeds up how fast you lose it.
More likely if: alcohol intake is on the higher side.
Some medicines
Methotrexate and some anti-epileptic medicines can lower folate levels.
More likely if: on long-term medicines that affect folate.
Higher turnover
Some blood and skin conditions use up folate faster than usual.
Your GP will consider this if relevant to you.
Why we check your B12 before treating folate. Low folate and low B12 cause very similar blood changes, and they often travel together. Treating folate alone can "tidy up" the blood while a hidden B12 problem quietly continues — which can affect the nerves. So we check both, and sort B12 first if needed. It's a simple step that keeps you safe.
Folate-friendly foods & habits
1
Eat your greens
Broccoli, spinach, peas, Brussels sprouts
2
Beans & citrus
Lentils, chickpeas, oranges & berries
3
Cook gently
Folate is lost in long boiling — steam or stir-fry
4
Mind the alcohol
Cutting back helps your folate recover
See your GP if you also have
- Tiredness that lingers or is getting worse
- Breathlessness, palpitations or looking pale
- A sore or smooth tongue, or mouth ulcers
- Numbness or tingling (we'll check your B12)
- You're pregnant, or planning a pregnancy
- Tummy symptoms suggesting absorption trouble
What your GP can do
- Confirm low folate with a simple blood test
- Check your B12 and iron at the same time
- Prescribe folic acid tablets — usually a short course
- Look for a cause, such as coeliac disease
- Advise on folate-rich foods for the long term
- Recheck your bloods to confirm it's recovered
Worth noting before your appointment: how long you've felt tired, and how it's changed; what a typical week of meals looks like; your alcohol intake, honestly; any tummy or bowel symptoms; whether you're pregnant or planning to be; all medicines and supplements you take.
An Easy One to Fix
Low folate is common, easily treated, and usually nothing to worry about. We'll find why it dropped, put it right, and check it's stayed up.
— Dr Regu
