Vitamin B9 Deficiency

There are 8 essential B vitamins. One of them, vitamin B9 or folate/folic acid, works in our bodies to help with DNA synthesis, acting as a coenzyme. This vital nutrient, also known as folic acid or folate, is required for normal cell division. Cell division in our bodies is the way we stay alive and how we thrive. When cellular division is compromised, due to vitamin B9 deficiency, some important processes go wrong and disease results.

Causes of Vitamin B9 Deficiency

Deficiency of this important vitamin is fairly common, occurring frequently in alcoholics and people with digestive disorders such as Crohn's disease and colitis. Any inflammatory condition of the colon or small intestines can result in reduced absorption of folic acid. Alcoholics are also prone to this deficiency primarily due to a lack of proper diet and reduced absorption.

Prescription drugs can also cause vitamin B9 deficiency. Examples include cholestyramine, methotrexate, and chemotherapy drugs.

Sometimes the deficiency will occur even with a lack of any of these issues. Many people have difficulty absorbing the vitamin or they simply do not get enough in the diet.

How do You Know If You Have a Vitamin B9 Deficiency?

The best way to find out is to get regular blood work as the deficiency typically does not produce any symptoms until later stages. Supplementation is generally advised if you are at risk, but your physician can provide advice concerning chronic deficiencies.

Some of the primary symptoms of deficiency include mood disorders such as depression accompanied by anemia. Without enough folic acid, growth retardation, glossitis, diarrhea, anorexia, difficulty breathing, macrocytic anemia, severe headaches, heart issues, and weight loss can occur.

Some diseases such as lymphomas, cervical dysplasia, peripheral vascular disease, and seizure disorders are associated with chronic folic acid deficiency.

Symptoms of Anemia

When anemia finally sets in, there will be deformations in blood cells or even a lack of blood cells. Again, this may not be noticeable at first, but eventually, the following symptoms will occur due to vitamin B9 deficiency anemia:

  • Lack of energy
  • Light headedness or dizziness
  • Getting cold easily
  • Chronic headaches and irritability
  • Breathing problems
  • White, pasty looking skin
  • Appetite problems
  • Rapid loss of body weight
  • Chronic diarrhea
  • Attention deficit disorder and other problems with concentration problems

Problems Associated with Vitamin B9 Deficiency

There are a number of health issues which can occur when the body does not get the daily required amount of folic acid. As a vitamin, it does not stay in the body very long and it must be consumed daily in order to avoid the following health problems:

1. Birth Defects

The required amount of folic acid for women who are pregnant is in the range of 600 to 800 mcg daily. When this amount is not consumed daily, there are serious risks for birth defects. Fetal brain development is impaired by a lack of folic acid because DNA expression becomes aberrant. Fetal development becomes impaired.

Sufficient intake of folic acid is also important to reduce homocysteine, a toxic metabolite of the amino acid methionine. Folic acid and vitamin B-12 help reduce homocysteine back into methionine. High levels of homocysteine are associated with heart disease in all individuals. In women who are pregnant, high levels of this toxic metabolite can easily result in miscarriage or placental abruptions. It is vital for women to have plenty of B9 supplementation during the first four weeks of pregnancy at least.

2. Cancer

Since vitamin B9 is so closely involved with genetic expression through proper synthesis of DNA, the code for all cellular development, deficiencies of the vitamin can result in increased cancer risks. Cancerous cells can indeed grow and proliferate faster in the presence of folic acid. Colon cancer is the most common cancer associated with folic acid deficiency disorders. There have been studies which report a reduction of risk for colon cancer development with increased intake of vitamin B9, folate.

3. Heart Disease

Over the years, physicians have come to realize a strong link between heart disease and elevated homocysteine levels. As mentioned earlier, this is a harmful metabolite of the essential amino acid methionine. Homocysteine occurs naturally in the body, but it can become so highly elevated as to cause vascular and heart damage and vitamin B9 deficiency can cause this. This results in heart disease.

The biologically active form of folic acid to reduce homocysteine and improve resistance to cardiovascular disease is called methylfolate. It works in conjunction with methylcobalamin, the active form of Vitamin B12, to mitigate homocysteine levels. In fact, an estimated 13,500 cardiac related deaths annually are associated with folic acid deficiency. Supplementation can reduce this risk by up to 15% according to physicians.

How Is Vitamin B9 Deficiency Treated?

1. Supplementation

In most cases, the deficiency can be easily treated with folic acid injections or tablets by increasing the levels of B9 vitamin in your body. It takes about four months of folate supplements to fully correct a serious deficiency. There are cases in which it could take longer for the proper health to be restored.

2. Diet High in Folic Acid

Supplementation is important, but maintaining a diet high in folic acid will also be helpful. There are a number of foods which are high in this helpful vitamin:

  • Leafy greens           
  • Corn
  • Legumes
  • Romaine lettuce
  • Asparagus
  • Spinach
  • Carrots
  • Pasta
  • Cereal
  • Peas
  • Breads (preferably whole wheat)
  • Citrus fruits and juices
  • Beer
  • Melons
  • Bananas
  • Berries such as raspberries
  • Beets
  • Broccoli
  • Tomatoes
  • Cabbages like Bok Choy
  • Liver
  • Brewer's yeast or nutritional yeast

Dietary Daily Intake Amounts Recommended by RDA


Recommended Ammount

0 to 6 months


7 to 12 months


1 to 3 years


4 to 8 years

200 mcg

9 to 13 years


14 to 18 years


19 years and older


Pregnant women


Breastfeeding women


Important Precautions

While low dietary intake of folic acid can obviously result in some serious problems, taking too much can produce other risks. It is best to consult your medical dietician or physician about safe levels of folate to take and what form you should take it in.

  • Generally, you don't want to exceed 1,000mcg of folic acid daily, even with vitamin B9 deficiency. It is difficult to overdose on a water soluble vitamin. Extremely large doses can lead to risks of seizures, mania, problems with digestion, sleep problems, unusual skin rashes, and other problems.
  • It is recommended that people with epilepsy keep intake at a practical level or seizure frequency could increase.
  • Finally, taking too much folic acid beyond 1000mcg daily can hide signs and symptoms of vitamin B12 deficiency.
  • Using single B vitamins in supplementation can result in imbalances with other B vitamins. It is best to use a simple B-complex to cover all the bases.
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