Folate · low result
What does a low Folate mean?
Short answer
Low folate is usually dietary — few leafy greens, legumes or fortified grains — or from alcohol use, malabsorption (celiac disease), pregnancy's higher demand, or medications such as methotrexate, some anticonvulsants and sulfasalazine. It causes macrocytic anemia and fatigue, raises homocysteine, and in pregnancy raises the risk of neural-tube defects. B12 should be checked alongside, since treating folate alone can mask B12 deficiency.
Medically reviewed by Youmna DiStefano, MD · Last reviewed September 2026
What is the normal range for Folate?
- age 18+: 3.40 – 25.0 ng/mL
Can reflect poor diet, alcohol use, certain medications, or absorption issues. Especially important before/during pregnancy.
Full reference table, citations and testing options: Folate biomarker page.
What are the common causes of low Folate?
- Low dietary intake, alcohol use disorder
- Malabsorption: celiac disease, inflammatory bowel disease, bariatric surgery
- Pregnancy, breastfeeding, hemolytic anemia (increased demand)
- Medications: methotrexate, phenytoin, trimethoprim, sulfasalazine
- Some genetic variants (MTHFR) modestly affect folate metabolism
What symptoms go with low Folate?
- Fatigue, weakness
- Sore tongue, mouth ulcers
- Irritability, low mood
What do clinicians usually check next?
- Vitamin B12 (must be checked before treating folate alone)
- CBC with MCV
- Celiac screen if no dietary or medication cause
- Homocysteine if cardiovascular risk is being assessed
Follow-up tests available at TestWell: CBC with Differential ($21.99), CBC (Complete Blood Count) ($21.99), Homocysteine ($27.99), Vitamin B12 ($25.99).
How do you recheck Folate?
Prices are cash-pay; every order adds one $6 lab processing fee. Physician authorization is included; no insurance or referral needed.
| Test or panel | Type | Price | Fasting | Results |
|---|---|---|---|---|
| Vitamin B12 & Folate | Test · 2 biomarkers | $36.99 | No | 2–4 business days |
Common questions
Why check B12 when folate is low?
Treating folate deficiency corrects the anemia but not the nerve damage of an undiagnosed B12 deficiency, which then progresses silently. Both are always checked together.
Sources
Educational content, not a diagnosis. Lab results are one input; a clinician interprets them with your history and exam.