Most people know that a relatively high intake of folic acid is necessary for a healthy pregnancy. However, fewer are aware of just how important this B vitamin can be for overall well-being. For example, folic acid is involved in the production and repair of DNA, as well as the creation of red blood cells. In severe cases, folate deficiency anemia can develop—a type of anemia in which blood cells become enlarged and their functionality is impaired.
Most cases of folate deficiency come from poor diet, but it’s also possible for excessive alcohol consumption, certain bowel disorders, cancer and inflammatory diseases to play a role. Here are ten major warning signs that you might be deficient in folic acid, along with some straightforward advice that will help you boost your dietary intake.
1. Tongue changes
One of the most prominent indications of a folate deficiency is glossitis—a painful, reddened tongue that is tender to the touch. You may first notice glossitis when it hurts to swallow or speak, or you may spot the change in color when you examine your tongue because you feel it is swelling. A tongue with glossitis will also typically have a smoother surface, due to the disappearance of normal bumps called papillae. Your dentist may mention this change to you before any pain even starts.
If you ever experience a sudden onset of extreme numbness, seek medical care immediately (especially if the numbness is one-sided, as this can indicate a stroke). However, if you’re suffering from reduced feeling in your feet and hands, a folate deficiency may be the cause. The numbness may be paired with irritating pins and needles sensations in your extremities. A neurological workup may be necessary, but it’s smart to rule out simpler problems like low folate levels before any more serious causes are investigated.
A lack of adequate folic acid in your system can also influence your mental health, chiefly by lowering your mood. If you don’t have a history of depression and aren’t struggling with traumatic life changes, a quick blood test can tell you if a folate shortage may be the culprit. Meanwhile, other people with a folate deficiency report irritability rather than depression, so note that a short temper can also be a symptom.
4. Extreme tiredness
Just as iron deficiency anemia can cause lethargy, so too can folate deficiency anemia. Patients often complain of waking feeling unrested, reduced tolerance to exercise, and breathlessness. These symptoms develop because abnormally large red blood cells are incapable of effectively carrying hemoglobin (and therefore oxygen) around the body.
5. Cognitive impairments
The cognitive impairments associated with a folate deficiency can be similar to the symptoms of dementia—especially if your deficiency is severe. You may struggle to remember things (especially information stored in your short term memory), it may be harder for you to process new facts, and others might note that your judgment seems to be impaired.
6. Weakened muscles
Muscle weakness can become apparent when you’re having a hard time doing a workout that used to be easy, or even when you’re just walking up the stairs and find yourself wondering if you can make it to the top. Your muscles may also feel achier than usual after moving around.
7. Mouth ulcers
Most people get a mouth ulcer every now and again—these round sores can really hurt (especially if they’re on the inside of your cheeks or gums), but they are generally harmless. If you start developing constant mouth ulcers or repeated crops of numerous mouth ulcers, everything from stress to hormonal fluctuations could be playing a role. However, folate deficiency is a relatively common cause of recurrent mouth ulcers, so take them seriously—especially if they are seen in conjunction with several other symptoms on this list.
8. Changes in skin tone
Any type of anemia can lead to paler skin, so if people keep remarking that you look like you’re under the weather then it may be time to have your blood tested. However, folate deficiency can also cause you to develop a pale complexion that has yellow undertones. So, for example, if you apply makeup and find that your usual foundation and concealer no longer seem to match your skin, a lack of folic acid could be the reason.
9. Greying hair
Some people go grey younger than others, but if you’re barely past 20 and noticing grey hairs coming in then it could be down to low folate levels. Problems with the thyroid gland or pituitary gland can also cause these changes in hair pigmentation. If it turns out that there is an underlying medical issue, then the good news is that your newly greying locks could return to their former glory once the imbalance is addressed with treatment.
10. Digestive upset
Finally, a folate deficiency frequently prompts uncomfortable changes in digestive function. Diarrhea is the most common presentation, but you may also experience trapped wind, bloating or intestinal cramps.
Do not hesitate to ask your doctor to test your folate levels if you are concerned about the above symptoms. Daily doses of folic acid can quickly help you to feel better, but it’s also worth considering how you might improve your diet. Some of the best food sources of folate include fortified breads and cereals, brown rice, asparagus, broccoli, peas and Brussels sprouts.