Folate and B12 Blood Test

Causes of Deficiency

Folate deficiency anaemia and vitamin B12 deficiency anaemia occur when your body cannot produce enough healthy red blood cells due to a lack of these essential vitamins. This type of deficiency anaemia can develop for several reasons, often depending on how much dietary folate you consume, how well your digestive system absorbs these nutrients, and whether your body’s demand for them increases—such as during pregnancy.

One of the most common causes of vitamin B12 deficiency is a condition called pernicious anaemia. In this autoimmune condition, the immune system produces antibodies that attack healthy cells in the stomach, specifically those responsible for making a protein called intrinsic factor. Without intrinsic factor, your body cannot absorb vitamin B12 properly, leading to a gradual decline in red blood cell production and, eventually, severe anaemia and neurological complications involving the brain and spinal cord.

Folate deficiency can be caused by a generally poor diet, malabsorption issues, or certain inherited blood disorders. Conditions such as congenital folate malabsorption, acute liver damage, or chronic infections can also lead to low folate levels. Additionally, medications like proton pump inhibitors, which are used to treat acid reflux, can interfere with your body’s ability to absorb folate. Prolonged poor diet and insufficient intake of specially fortified foods or folate supplements can further increase the risk.

If folate deficiency anaemia continues untreated, it can result in fewer red blood cells, underdeveloped or immature red blood cells (megaloblastic anaemia), and a lack of the substance called haemoglobin, which is vital for carrying oxygen throughout the body. This can cause extreme tiredness, heart and lung complications, and, in severe cases, developing heart failure. In pregnancy, untreated folate deficiency anaemia increases the risk of serious birth defects, such as neural tube defects like spina bifida, and other pregnancy complications.

Blood tests are essential for diagnosing b12 or folate deficiency and determining the underlying cause. If blood test results suggest a deficiency, additional blood tests may be needed with your GP to pinpoint the exact reason, whether it’s an autoimmune condition, poor diet, or another health issue. Treating folate deficiency anaemia usually involves folic acid tablets or supplements to restore folate levels, but the most appropriate treatment depends on addressing the root cause—whether that’s improving dietary folate intake, managing an underlying blood disorder, or treating an autoimmune condition.

Cardiovascular disease research has also linked folate deficiency to an increased risk of heart or blood vessel problems. Missing vitamins like folate and vitamin B12 can have wide-ranging effects, from neurological complications to lung complications and damage to healthy cells. That’s why it’s crucial to absorb folate efficiently and maintain healthy folate levels through a balanced diet, fortified foods, and, when necessary, medical treatment.

If you experience symptoms suggestive of deficiency anaemia—such as extreme tiredness, neurological symptoms, or signs of heart or lung complications—further tests and prompt treatment are vital to prevent long-term health issues.

What does the test involve?

• We use a finger prick blood test – quick and easy!
• Checking the size and number of red blood cells (to spot underdeveloped or immature red blood cells)

Why is the Test Important for Detecting Folate Deficiency Anaemia?

B12 or folate deficiencies can develop due to a generally poor diet, certain health conditions affecting the digestive system (like coeliac disease), medications (e.g., proton pump inhibitors), prolonged poor diet, or inherited blood disorders. Folate deficiency can be caused by poor diet, malabsorption, medication use, or increased bodily needs. These deficiencies may not only cause anaemia (when the body makes fewer red blood cells) but can also result in neurological complications and—in pregnancy—serious birth defects such as neural tube defects (like spina bifida).

Testing can help:

• Identify deficiency anaemia (including folate deficiency anaemia and pernicious anaemia)
• Guide appropriate treatment (such as folic acid tablets and B12 supplements or injections)
• Prevent complications such as neurological symptoms, heart and lung complications, problems with the heart or blood vessels, and pregnancy complications

Risk factors include frequent urination or certain medications, which can cause you to lose folate from your body.

What Symptoms Related to Red Blood Cells Might Suggest You Need This Test?

You may benefit from a Folate and B12 Blood Test if you experience:

• Extreme tiredness or fatigue
• Weakness
• Pale skin
• Shortness of breath or heart palpitations
• Mouth ulcers
• Poor memory, confusion, or depression
• Tingling or numbness (neurological symptoms)
• History of poor dietary intake or digestive disorders

Anaemia complications can include developing heart failure or lung complications if severe anaemia continues untreated.