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Serum Folate (Vitamin B9)


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The Folate Test is a medical test that measures the level of folate in the blood. Folate, also known as folic acid or vitamin B9, is an essential nutrient that plays a critical role in many bodily functions, including cell growth and division, DNA synthesis, and red blood cell production. Folate deficiency can lead to a variety of health problems, including anemia, birth defects, and neurological disorders. The folate test is used to diagnose and monitor folate deficiency and related conditions. It involves drawing a small sample of blood from an arm vein and measuring the level of folate in the serum or red blood cells. The test is simple, safe, and relatively quick to perform. Results are usually available within a few days.

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Purpose of the test

The Folate Test is ordered by healthcare providers for a variety of reasons. Primarily, the test is used to diagnose and monitor folate deficiency, a condition that occurs when the body does not have enough folate to function properly. Folate deficiency can lead to anemia, a condition in which there are not enough red blood cells in the body to carry oxygen to the tissues. Anemia can cause symptoms such as weakness, fatigue, shortness of breath, and pale skin. Folate deficiency can also cause other health problems, including birth defects in pregnant women and neurological disorders such as depression, confusion, and memory loss.

The Folate Test may be ordered if a patient is experiencing symptoms of folate deficiency or has risk factors for the condition. Risk factors for folate deficiency include poor diet, alcoholism, malabsorption syndromes such as celiac disease or inflammatory bowel disease (IBD), certain medications such as methotrexate or phenytoin, and pregnancy.

In addition to diagnosing and monitoring folate deficiency, the folate test can be used to assess patient health in other ways. For example

- The test may be ordered before or during pregnancy to ensure that the mother has adequate folate for fetal development.
- The test may be ordered before starting certain medications that can decrease folate levels.
- The test may be ordered as part of a routine blood test to assess overall health.

It is important to identify folate deficiency early so that it can be treated promptly with folic acid supplements or dietary changes. If left untreated, folate deficiency can lead to serious health problems such as anemia and birth defects. In addition, some studies suggest that low folate levels may increase the risk of certain cancers and cardiovascular disease.

In summary, the goals of folate testing are to

- Diagnose and monitor folate deficiency
- Assess patient health in various contexts, such as pregnancy or medication use
- Detect folate deficiency early and prevent serious health problems
- Identify potential risk factors for folate deficiency and related conditions.

Who Should Get Tested

The Folate Test is indicated for a variety of people who may be at risk for folate deficiency or related conditions. These include

- Pregnant women: Folate is essential for fetal development, and pregnant women are often advised to take folic acid supplements to prevent birth defects. The folate test can help ensure that a pregnant woman has adequate folate levels.
- People with poor diets: Folate is found in many foods, including green leafy vegetables, fruits, and fortified cereals. People who do not eat a balanced diet may be at risk for folate deficiency.
- People with malabsorption syndromes: Certain medical conditions, such as celiac disease or inflammatory bowel disease (IBD), can interfere with the body's ability to absorb nutrients, including folate.
- People taking certain medications: Some medicines, such as methotrexate or phenytoin, can decrease folate levels in the body.
- People with anemia or other symptoms of folate deficiency: Symptoms of folate deficiency include weakness, fatigue, shortness of breath, and pale skin. The folate test can help diagnose these symptoms and determine if they are caused by low folate levels.

It is important to note that not everyone needs to be tested for folate levels. In general, healthcare providers will order the test if there is a specific reason to suspect that a patient may have low folate levels. If you are not sure whether you need to be tested for folate levels, talk to your healthcare provider.

Blood Test Preparation Guidelines
Time of day
It is recommended to schedule your appointment for blood tests in the morning hours between 7:00-10:00.
It is recommended to fast for approximately 12 hours before blood sampling. The last meal of the previous day should ideally be consumed around 6:00 p.m. On the day before the test, avoid heavy and fatty meals as well as alcohol.
Stay hydrated
Drinking water prior to testing can help with sample collection.
Other factors
Tests should not be performed after a sleepless night or intense physical activity. It is recommended to avoid exercise and stress immediately before blood collection and to not smoke. A short rest is recommended.
Medications and supplements:
Blood samples should be collected before the morning dose. Some drugs can interfere with test results. Consult with your doctor whether you can delay your dose because of lab tests.
Biotin supplements:
High doses of biotin supplements can affect test results, causing false elevation or reduction. It's recommended to avoid taking biotin for at least 72 hours before blood collection. If you are taking biotin, inform the personnel collecting the blood so that they can provide specific instructions.
Interpreting Test Results

The results of a folate test are usually reported as a numerical value in nanograms per milliliter (ng/mL) or nanomoles per liter (nmol/L). The normal range for folate levels may vary depending on the laboratory performing the test, but in general, a normal range for serum folate is between 2.7 and 17.0 ng/mL (6.2 and 38.7 nmol/L), while a normal range for red blood cell folate is between 140 and 628 ng/mL (317 and 1423 nmol/L).

If the results of a folate test are outside the normal range, it may indicate that the patient has a folate deficiency or related condition. However, it is important to note that abnormal results do not necessarily mean there is a problem, as there are many reasons why folate levels may be low or high.

Interpretation of test results requires clinical judgment by a healthcare provider, taking into account the patient's medical history, symptoms, and other factors. In general:

- Low serum or red blood cell folate levels may indicate folate deficiency.
- High serum or red blood cell folate levels are generally not considered problematic and may be due to recent folic acid supplementation.
- Abnormal results should be followed up with additional testing to confirm the diagnosis and determine appropriate treatment.

You should be aware that interpretation of test results requires clinical judgment by a healthcare provider, taking into account the patient's medical history, symptoms, and other factors. Patients should discuss their test results with their healthcare provider to ensure accurate interpretation and appropriate follow-up.

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