Folate
Folate
Does this test have other names?
Vitamin B-9, folic acid test
What is this test?
This is a blood test to measure the concentration of folate in the liquid part of your blood, called serum, or in your red blood cells. The concentration in the red blood cells will be higher than in the serum.
Folate is a B vitamin naturally found in:
Leafy green vegetables, such as spinach, kale, collards, and romaine lettuce
Citrus fruits and juices
Dried beans, lentils, and peas
Yeast
Liver
Asparagus
Broccoli
Wheat germ
Many cereals, breads, and other grain products are fortified with folic acid, the synthetic version of folate.
Folate is needed to make red blood cells. It is also used to repair cells and to make DNA.
It also helps prevent cellular changes that may lead to cancer. Folate is also needed to help a baby's cells multiply during pregnancy. Low levels of folate during pregnancy can lead to brain or spine defects in the fetus. It can also lead to megaloblastic anemia. This is a type of anemia marked by fewer, but larger, red blood cells.
Why do I need this test?
You may need this test to find out the cause of anemia, look at your nutritional status, or monitor a previous folate deficiency.
If you have anemia, you don't have enough red blood cells to carry oxygen to the cells in your body. A folate deficiency is just one cause of anemia. If you don't get enough folate or folic acid from food or vitamins, you may end up with a folate deficiency. Symptoms include:
Fatigue
Weakness
Pale skin, gums, eyes, and nails
Mouth ulcers and a red, sore tongue
Irritability
Shortness of breath
Weight loss
Numbness and tingling of fingers and toes
Forgetfulness
Confusion
Dizziness and fainting
Nausea, vomiting, diarrhea, although these are rare
What other tests might I have along with this test?
Your healthcare provider may also order a vitamin B-12 test. Both folate and B-12 are important to for healthy red blood cells. A deficiency in either B-12 or folate can cause anemia.
What do my test results mean?
Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you.
For blood plasma or serum, a normal result ranges from 2 to 10 nanograms per milliliter (ng/mL) or 4 to 22 nanomoles per liter (nmol/L).
For red blood cells, a normal result ranges from 140 to 960 ng/mL or 550 to 2,200 nmol/L.
A test result that's lower than normal means you have a folate deficiency, and your healthcare provider may recommend folic acid supplements. Once you begin taking supplements, the folate deficiency will go away within a few months. Your healthcare provider determines how much of a folic acid supplement you need based on your age and whether you are pregnant or breastfeeding.
Folate is water soluble, so any extra folate leaves your body in urine. But a buildup can sometimes happen during folic acid therapy.
How is this test done?
The test is done with a blood sample. A needle is used to draw blood from a vein in your arm or hand.
Does this test pose any risks?
Having a blood test with a needle carries some risks. These include bleeding, infection, bruising, and feeling lightheaded. When the needle pricks your arm or hand, you may feel a slight sting or pain. Afterward, the site may be sore.
What might affect my test results?
Many factors can contribute to a folate deficiency, including:
Poor nutrition
Being a vegetarian
Drinking too much alcohol
Advanced age
Smoking
Anti-seizure medicines
Chemotherapy
Pregnancy
Recent surgery
Nutrition absorption problems (Crohn's or celiac disease)
Kidney dialysis
How do I get ready for this test?
You don't need to prepare for this test. Be sure your healthcare provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illicit drugs you may use.
Updated:  
October 06, 2017
Sources:  
Etiology and clinical manifestations of vitamin B12 and folate deficiency. UpToDate., Ferri F. Ferri's Clinical Advisor. 2012; ed.1.
Reviewed By:  
Greco, Frank, MD,Walton-Ziegler, Olivia, MS, PA-C