Folic Acid Deficiency: What It Looks Like and How to Fix It

Worried you might be low on folic acid (folate)? It’s common and easy to treat — but you want to catch it early. Below I’ll show you how to spot the signs, what causes it, how doctors test for it, and simple steps you can take right now to bring your levels back to normal.

How to spot it fast

Look for these clear signs: feeling tired or weak, pale skin, shortness of breath during light activity, mouth sores, and an irritated tongue. Sometimes people notice trouble concentrating or mild forgetfulness. If the deficiency is longer-term, you may get tingling or numbness in your hands and feet — but that can also mean B12 issues, so don’t guess.

Pregnant people need to pay special attention. Low folate during early pregnancy raises the risk of neural tube defects in the baby. That’s why folic acid for women of childbearing age is a big deal.

Fixing deficiency: food and supplements

Start with food. Eat more leafy greens (spinach, kale), lentils, chickpeas, asparagus, and fortified cereals or bread. Those foods raise folate naturally and help long-term. A simple plate idea: add a cup of cooked spinach or a serving of lentils a few times a week.

Supplements are often needed. For most adults, a multivitamin with 400 mcg (0.4 mg) of folic acid is enough. Women planning pregnancy should take 400 mcg daily before conception and during early pregnancy; pregnant women usually need about 600 mcg daily. If a doctor confirms deficiency, treatment commonly uses 1,000 mcg (1 mg) of folic acid per day for a few months — but follow your provider’s advice.

Quick tips: take folic acid with a meal to reduce stomach upset. If you drink heavily or take certain meds, talk to your doctor — alcohol and drugs like methotrexate, trimethoprim, and some seizure medicines lower folate levels.

Testing is simple. A blood test can check serum folate or red blood cell folate. If fatigue or anemia is present, your doctor may also test hemoglobin and vitamin B12. Why both? Because folic acid can hide a B12 deficiency and leave nerve damage untreated if you only treat folate.

If you’re on medications, pregnant, breastfeeding, or have digestive problems (like celiac disease), tell your clinician — you might need higher doses or closer monitoring. And if symptoms include severe weakness, fast heartbeat, or breathlessness, seek medical care promptly.

Small changes make a big difference: add folate-rich foods, use a daily vitamin with folic acid if you can get pregnant, check for interactions with medicines, and get a simple blood test if you feel off. That’s the fastest way back to normal energy and lower risk for complications.