What are serum folate: 4 things you need to know
Folate is a group of related compounds with similar nutritional properties, being essential micronutrients that the human body can not synthesize, thus depending on the exogenous intake.[1]
In this article we will talk about the important role they play, when and why it is recommended to determine their level and what are the normal values, but also about the risks associated with a level of low serum folate.
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What is the role of folate
Folate is the natural form of vitamin B9 and helps in the formation of DNA and RNA, being also involved in protein metabolism. It also plays an extremely important role in the breakdown of homocysteine, an amino acid that can have harmful effects on the cardiovascular system if present in large quantities.
Our body also needs folate to produce healthy red blood cells; It is essential during periods of rapid growth, such as during pregnancy and fetal development. [3]
Folate is naturally present in many foods, including:
– Beef liver;
– Vegetables, especially asparagus, Brussels sprouts and green leafy vegetables;
– Fruits and fruit juices (especially oranges);
– Nuts;
– Green peas.
Folate and vitamin B12 deficiencies are considered the most common causes of macrocytic anemia. Low folate levels can have other negative effects on health, such as: cardiovascular disease, neoplastic disease and cognitive dysfunction, an increased risk of abruptio placentae, preeclampsia, miscarriage, stillbirth, premature birth, low birth weight , cleft palate and severe congenital anomalies of the brain and spine, such as neural tube defects.[5]
How folate levels can be determined
Laboratory tests for folate and vitamin B12 are essential for diagnosing a possible deficiency of these vitamins and for investigating some forms of anemia. Serum folate levels, erythrocyte folate levels or vitamin B12 levels can be measured.
The first type of test commonly used to determine whether or not there is a deficiency is the determination of serum folate (reference range 7-40 nmol / L). The safety margin between intake and folate intake is small, so their level may fall below normal values after only 3 weeks of negative balance (folate intake exceeds intake).
Low folate levels may indicate a deficiency in the body, but it should be noted that serum folate levels also depend on recent dietary intake. In general, if the level of serum folate is abnormal, that of erythrocyte folate is also measured. In the case of a patient with folate deficiency who has recently been given folic acid, only measuring the level of erythrocyte folate will lead to the detection of that deficiency.[4]
When it is recommended to test the level of serum folate
There are several reasons why such a test may be necessary, including:
– Low folate levels can lead to anemia;
– The test can be used to investigate possible causes of nerve damage;
– Some conditions, such as Crohn’s disease or cystic fibrosis, prevent the absorption of folate in the body;
– Folate deficiency can cause confusion and disorientation in some cases;
– The test can help monitor treatment for folic acid or vitamin B12 deficiency.
What can be the causes of decreased folate levels
Decreased folate levels can have several causes:
– Do not eat enough foods rich in folate;
– Your body does not absorb folate from food;
– Certain medications or liver or kidney disease can lower folate levels;
– If you are pregnant, you may need more folate than normal.[2]
The results of the tests may vary depending on age, sex, medical history, test method used, but also other factors. If they indicate a low level of serum folate, it does not necessarily mean that you have a problem. Your doctor is the only one who can tell you exactly what those results mean to you.
Bibliography:
Atli Arnarson BSc, PhD. “Folic Acid vs. Folate — What’s the Difference?” Healthline, Healthline Media, 19 Aug. 2019, www.healthline.com/nutrition/folic-acid-vs-folate#folate. Accessed 28 Jan. 2022.
“Folate Test.” Healthdirect.gov.au, Healthdirect Australia, 24 Nov. 2020, www.healthdirect.gov.au/folate-test. Accessed 28 Jan. 2022.
Harvard T.H. Chan. “Folate (Folic Acid) – Vitamin B9.” The Nutrition Source, 18 Sept. 2012, www.hsph.harvard.edu/nutritionsource/folic-acid/. Accessed 28 Jan. 2022.
Metz, Jack. “Results: Appropriate Use of Tests for Folate and Vitamin B12 Deficiency.” Australian Prescriber, vol. 22, no. 1, 1 Feb. 1999, pp. 16–18, www.nps.org.au/australian-prescriber/articles/appropriate-use-of-tests-for-folate-and-vitamin-b12-deficiency, 10.18773/austprescr.1999.010. Accessed 28 Jan. 2022.
“Office of Dietary Supplements – Folate.” Nih.gov, 2016, ods.od.nih.gov/factsheets/Folate-HealthProfessional/#h5. Accessed 28 Jan. 2022.
