Folic acid deficiency means that your body doesn’t have enough folic acid. Folic acid is the (wo)man-made form of folate (vitamin B9). This vitamin helps you produce red blood cells, which serve the vital function of transporting oxygen to all of your muscles and tissues. Folic acid deficiency anemia can make your body create abnormally large red blood cells which don’t work as they should. This makes the bone marrow produce fewer red blood cells. If you don’t have enough healthy red blood cells, this means you have a condition known as anemia.

Impact on fertility

Folic acid is one of the most crucial nutrients during pregnancy as it helps to prevent problems that can lead to miscarriage, including neural tube defects and chromosomal disorders, as well as complications like high blood pressure (preeclampsia). But it’s important when you’re trying to conceive too. Folic acid helps your eggs mature; not having enough may stop you from ovulating regularly.

Potential causes of folic acid deficiency anemia

This is usually caused by a lack of folic acid in the diet.
Other possible reasons for folic acid deficiency anemia include:

  • Excessive alcohol drinking
  • Digestive problems that make your body not absorb folic acid as it should, such as Crohn’s disease or celiac disease 
  • Certain medications including those used to treat seizures
  • Gluten intolerance
  • Liver disease
  • Genetic diseases
  • Hyperthyroidism

Overcooking your fruits and veggies can also destroy the natural folate in your food and lead to a deficiency.

Symptoms of folic acid deficiency anemia

Physical signs of folic acid deficiency anemia are:

  • Pale skin
  • Not feeling hungry
  • Irritable mood
  • Lack of energy
  • Diarrhea
  • Shortness of breath
  • Dizziness


Doctors diagnose folic acid deficiency anemia through blood tests to check your red blood cell count and hemoglobin level and folic acid level. Other lab tests may include a peripheral blood smear, where a healthcare provider examines the size and shape of your blood cells under a microscope, and a reticulocyte count, which determines if your bone marrow is producing enough red blood cells.

Vitamin B12 deficiency can occur simultaneously with folic acid deficiency, so healthcare providers will often check your levels of this vitamin as well.

Treatment to improve fertility

Thankfully, the impact of folic acid deficiency on fertility is just temporary. With the right supplementation, you can get your folic acid levels back on track and improve your fertility. Taking folic acid supplements is associated with higher pregnancy rates and better embryo quality, studies show.

On top of the benefits for your fertility, it’s very important to treat anemia to support your heart and overall health. Usually, folic acid deficiency anemia improves within 3 to 6 months of beginning treatment. Once you increase your folic acid levels, you should notice that you have more energy than before.

So, how much folic acid do you need? Medical guidelines say that all women of childbearing age should take a 400 microgram supplement of folic acid daily. Some women may need a higher dose of folic acid in case there’s a greater chance that their pregnancy could be affected by neural tube defects.

Pregnant women are also at higher risk of having iron deficiency anemia, so it’s a good idea to take a prenatal vitamin including both folic acid and iron. Have a chat with your doctor about choosing the supplement that’s right for you.

Besides supplementation, be sure to eat a healthy, balanced diet with plenty of folate.

Here are the foods containing folate that you should add to your plate:

  • Leafy green vegetables
  • Broccoli
  • Brussels sprouts
  • Eggs
  • Beets
  • Citrus fruits
  • Lentils
  • Seeds
  • Nuts
  • Asparagus

If you’re curious, we have lots more helpful info on the right nutrition to boost your fertility naturally – check out our article on fertility foods here.

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