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Folic Acid Deficiency Anemia

Topic Overview

Red blood cells

What is folic acid deficiency anemia?

Folic acid deficiency anemia happens when your body does not have enough folic acid. Folic acid is one of the B vitamins, and it helps your body make new cells, including new red blood cells. Your body needs red blood cells to carry oxygen. If you don't have enough red blood cells, you have anemia, which can make you feel weak and tired. So it's important that you get enough folic acid every day.

Most people get enough folic acid in the food they eat. But some people either don't get enough in their diet or have trouble absorbing it from the foods they eat. Talk to your doctor about whether you should take a daily vitamin with folic acid.

Pregnant women who do not get enough folic acid are more likely to have babies with very serious birth defects.

What causes folic acid deficiency anemia?

You can get folic acid deficiency anemia if:

  • You don't eat enough foods that contain folic acid. These include citrus fruits, leafy green vegetables, and fortified cereals.
  • You have a greater need for folic acid. This might happen if you are pregnant or have some medical problems, such as sickle cell disease.
  • Your body doesn't absorb enough folic acid. This might happen if you drink too much alcohol or have severe kidney problems that require dialysis.
  • You take certain medicines, such as some used for cancer, rheumatoid arthritis, and seizures.

What are the symptoms?

Anemia may make you:

  • Feel weak and tired.
  • Feel lightheaded.
  • Be forgetful.
  • Feel grouchy.
  • Lose your appetite and lose weight.
  • Have trouble concentrating.

How is folic acid deficiency anemia diagnosed?

Your doctor will examine you and ask questions about your past health and how you are feeling now. You will also have blood tests to check the number of red blood cells and to see if your body has enough folic acid.

The level of vitamin B12 will be checked too. Some people whose folic acid levels are too low also have low levels of vitamin B12. The two problems can cause similar symptoms.

How is it treated?

If you think you have anemia, it is important to see your doctor and get tested so you can get the right treatment. Being treated for a shortage of folic acid when your anemia is caused by something else can be dangerous.

To treat the anemia, you can take folic acid pills each day to bring your folic acid level back up.

After your folic acid levels are normal, eat foods rich in folic acid so you don't get anemia again. These foods include fortified breads and cereals, citrus fruits, and dark green, leafy vegetables.

Why is folic acid important before and during pregnancy?

Folic acid helps prevent neural tube defects, such as spina bifida. These are major birth defects in which the baby's brain or spine is not fully formed. These birth defects usually happen in the first few weeks of pregnancy, before a woman even knows she is pregnant.

If you are a woman who could get pregnant, experts recommend taking a daily vitamin to make sure you get enough folic acid. For folic acid to help, you need to take it every day, starting before you become pregnant. If you are pregnant and you have not been taking a vitamin containing folic acid, begin taking it right away.

Other Places To Get Help

Organizations

Centers for Disease Control and Prevention (CDC): Folic Acid
Web Address: www.cdc.gov/ncbddd/folicacid/index.html

National Anemia Action Council
Web Address: www.anemia.org

References

Other Works Consulted

  • Katz DL (2008). Appendices and resource materials, Folate. In Nutrition in Clinical Practice: A Comprehensive, Evidence-Based Manual for the Practitioner, 2nd ed., pp. 517–519. Philadelphia: Lippincott Williams and Wilkins.
  • Stopler T, Weiner S (2012). Medical nutrition therapy for anemia. In LK Mahan et al., eds., Krause's Food and the Nutrition Care Process, 13 ed., pp. 725–741. St Louis: Saunders.
  • Green R (2010). Folate, cobalamin, and megaloblastic anemias. In K Kaushansky et al., eds., Williams Hematology, 8th ed., pp. 533–563. New York: McGraw-Hill.
  • U.S. Preventive Services Task Force (2009). Folic acid to prevent neural tube defects. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsnrfol.htm.

Credits

By Healthwise Staff
E. Gregory Thompson, MD - Internal Medicine
Joseph O'Donnell, MD - Hematology, Oncology
Last Revised December 18, 2012

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