Folic acid deficiency anaemia

Your body needs folic acid to make new cells in your body, including red blood cells.

You can get low in folic acid if you do not get enough from your food.

Some gut conditions, such as coeliac disease and Crohn's disease, and some medicines can also cause low folic acid.

Some blood disorders, such as sickle cell disease and thalassaemia, can lead to a very high turnover of red blood cells. Normal amounts of folic acid in the diet may not be enough.

If you are low in folic acid, you can get anaemia.

If you have anaemia, you might:

• feel tired and lightheaded
• be breathless
• look pale
• have a tender red tongue, mouth ulcers or loss of taste
• have difficulty concentrating and confusion
• feel your heart thumping (palpitations).

These symptoms happen because there is less oxygen in your body. Many people have no symptoms, and their anaemia is picked up by a blood test.

Your healthcare provider will ask about your symptoms and order a blood test. The blood test will measure your level of folic acid.

If your folic acid levels are low, eating more foods containing folates can help. Folate, also known as vitamin B9, is naturally found in many foods. Good sources of folate include:

• green vegetables such as broccoli, spinach, and salad greens
• citrus fruits
• wholegrain bread and breakfast cereals
• chickpeas, nuts, dried beans, and peas. Cooking these reduces the folate level.

Some foods are fortified with folic acid

All non-organic wheat flour used to manufacture bread in Aotearoa New Zealand must have folic acid added to it. This is called fortification.

Some types of flour do not need to be fortified. They are:

• wheat flour for organic bread
• flour made from other grains, such as rye
• wheat flour not specifically intended for breadmaking (such as for biscuits, cakes, pastry and pizzas).

Food manufacturers can choose to add folic acid to other foods, including:

• breakfast cereals
• fruit and vegetable juices
• milk alternatives, like soy milk
• food drinks (such as liquid meal supplements)
• gluten-free breads (for example, non wheat-flour bread).

If folic acid has been added, it will be on the ingredients list on the food packaging. Food makers can list this as folate or folic acid. It will sometimes be on the nutrition information panel.

Folate and the addition of folic acid to food — Ministry for Primary Industriesexternal link

Folic acid in pregnancy

Folic acid is very important for the healthy development of your pēpi during the early weeks of pregnancy. If you are planning to get pregnant it is recommended you start taking a folic acid supplement tablet for 4 weeks before you might become pregnant.

If you find you are pregnant and you have not been taking folic acid, start taking it as soon as possible.

Pregnancy nutrients and supplements

Low folic acid is treated by increasing the amount of food with folic acid that you eat.

You may also need to take folic acid tablets.