Causes of Folate Deficiency

Inadequate intake

Diet lacking raw green vegetables or enriched grains, chronic alcohol use disorder, parenteral nutrition

Impaired absorption

Celiac disease, sprue, other malabsorption syndromes, antiseizure medications, congenital or acquired folate malabsorption

Inadequate utilization

Folate antagonists (metformin, methotrexate, triamterene, trimethoprim), antiseizure medications, congenital or acquired enzyme deficiency, alcohol use disorder

Increased demand

Pregnancy, lactation, infancy, increased metabolism

Increased excretion

Renal dialysis (peritoneal or hemodialysis)