Folic acid (Vitamin B9)
Folic acid, or vitamin B9, is a water-soluble vitamin, which plays an important role in the proper working of brain functions, haematopoiesis, cell division, and the production and regeneration of genomes (DNA and RNA).
Due to the latter, adequate folic acid intake is especially important for expectant women, particularly in the first trimester, for proper foetal development, as folic acid is essential for the process of closing the foetal neural tube. Research also shows that with adequate folic acid levels, the risk of developing neural tube defect is significantly reduced.
Vitamin B12 is required for the intake and storage of folic acid in cells, so it is recommended that their levels be monitored simultaneously.
Folic acid cannot be produced by the body, it enters the body with food intake. Its main natural sources are dark green leafy vegetables (e.g. spinach), broccoli, cauliflower, brussels sprouts, cabbage, whole grains, legumes (e.g. beans) and liver.
What does the test show?
The test can be used to determine the level of folic acid in the body. Folic acid testing from a blood sample primarily helps diagnose a disease caused by larger than normal red blood cells (macrocytic anaemia) and helps to detect anaemia and folic acid deficiency.
In which cases is it recommended to perform the test?
Simultaneous testing of folic acid and vitamin B12 levels is most often requested by a specialist if the blood count confirms the presence of large red blood cells.
In case of symptoms suggestive of folic acid deficiency (weakness, fatigue, mood swings), the doctor may also request a test, usually with a vitamin B12 level test.
The test is also often ordered to find the cause of nerve damage in case of numbness, tingling or burning sensation in the limbs.
The determination of folic acid levels is also a common test when assessing general health, especially in cases of malnutrition or suspected malabsorption (e.g. Crohn’s disease, ulcerative colitis, gluten sensitivity).
Testing of folic acid levels may also be required to monitor the effectiveness of treatment after the diagnosis of folic acid deficiency.
What sample is needed for the test?
A blood sample taken from a vein is needed to perform the test.
Having an empty stomach is required for sampling. The results of this test may be affected by certain drugs, therefore talk to your doctor about the medicines you are taking before the blood collection.
What can the result indicate?
A lower folic acid level indicates folic acid deficiency. This can be caused by insufficient intake due to one-sided diet or overcooking of food, malabsorption caused by gluten sensitivity or the growth of certain bacteria in the gut, as well as kidney failure, liver disease, excessive alcohol consumption or side effects of certain drugs (e.g. oral contraceptives, medicine used to treat epilepsy).
Folic acid deficiency before pregnancy can be exacerbated during pregnancy, which can lead to preterm birth and foetal malformation.
Elevated folic acid values are a response to folic acid deficiency treatment. As a water-soluble vitamin, it cannot be overdosed. However, excessive folic acid intake may impair the clinical effect of some drugs or the utilization of zinc.
What to do after the test?
The finding alone does not constitute a diagnosis of any of the diseases listed above, so in all cases, consult the physician who ordered the test to determine the condition and the required therapy.