Folic acid (folate, folacin, vitamin B9)

Folic acid (folate, folacin, vitamin B9)

The most common term for this nutrient is folic acid, whereas vitamin B9 is hardly ever used. Folic acid is the synthetic form that is found in vitamin pills, while folate and folacin are the forms of the nutrient that are found naturally in food. Folic acid is very stable and gets converted into folate in the body. The vitamin is water-soluble. Most of it gets stored in the liver, which contains around half the body’s total amount of folate. The nutrient is destroyed by boiling and heating.

Planning of pregnancy

Folic acid reduces the risk of giving birth to a child with a neural tube defect. The neural tube of the fetus normally closes about a month after the time of conception and then continues developing into the brain and spinal cord. If the neural tube fails to close it may cause a deformity that prevents the brain from developing normally and may lead to stillbirth. Lack of folic acid may also cause heart defects and neural tube defect which can result in severe disabilities, including leg paralysis. Although these problems are relatively rare, it is advisable to take supplements of folic acid right from the time where the pregnancy is planned.

Deficiencies and poor utilisation may be caused by

  • Overconsumption of alcohol
  • Narcotics and medicine abuse
  • Pregnancy
  • Smoking
  • Poor intestinal flora
  • Unbalanced diets and inferior dieting strategies
  • Old age (especially in combination with an unbalanced diet)
  • Contraceptive pills
  • Cholesterol-lowering drugs (cholestyramine and Colestipol)
  • Epilepsy drugs (Phenytoin)
  • Methotrexate against rheumatism and cancer

Deficiency symptoms

  • Fetal damage (neural tube defects, heart defects)
  • Anemia (megaloblastic anemia), the same type as seen with vitamin B12 deficiencies. The symptoms occur because the cells lack oxygen. This may cause fatigue, heart palpitations, shortness of breath, dizziness, and in severe cases headache, heart cramp, and leg pain (intermittent claudication)
  • Impaired mental and physical development in the childhood (even though anemia does not occur)
  • Tongue infection with discolouring of the oral mucosa (glossitis)
  • Impaired sense of taste
  • Indigestion and intestinal gas
  • Diarrhea
  • Myelopathy (muscle disease)
  • Depression
  • Lack of folic acid is often accompanied by a vitamin B12 deficiency

Blood samples and diagnosis

Anemia and folic acid deficiency are detectable by means of a blood sample. An elevated level of the amino acid homocysteine in the blood also lends support to the diagnosis.


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