What is the Connection Between Cobalamin and Folate?

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  • Written By: Amy Hunter
  • Edited By: Andrew Jones
  • Last Modified Date: 21 December 2019
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Cobalamin and folate are related in that they both affect the body closely, and a deficiency or excess in one, can affect the levels of the other nutrient. For example, a person with low cobalamin levels may develop a folate deficiency. Someone with existing low levels of cobalamin who supplements his or her diet with only folate will likely worsen the cobalamin deficiency. It is important to get adequate levels of both cobalamin and folate. Consuming large amounts of folate, either through foods or supplements, can hide an existing cobalamin deficiency by correcting symptoms that would otherwise be visible.

Vitamin B-12 is the common name for Cobalamin. It is available in animal products, such as fish, poultry, meat, eggs, and milk. It is also added to cereals and breads, and is present in most basic vitamin formulations. The recommended daily allowance of cobalamin is 2.4 micrograms(mcg) daily.


Most healthy people in developed countries have sufficient intake of cobalamin. Older adults, and people who have trouble absorbing nutrients through digestion, such as those with reduced levels of stomach acidity, intestinal disorders, and people with pernicious anemia, are at an increased risk of experiencing a cobalamin deficiency. It is estimated that between 1.5 and 15 percent of the population of developed countries have some level of cobalamin deficiency. Symptoms of a deficiency in cobalamin include fatigue, constipation, loss of appetite, weight loss, weakness, and megaloblastic anemia, a condition where the red blood cells are larger than normal. A deficiency is typically treated with B-12 injections, to avoid absorption problems.

Folate is a water-soluble B vitamin. The synthetic version of folate is called folic acid. Folate is found in leafy green vegetables, as well as other vegetables such as asparagus and okra, fruits such as melons and bananas, lentils, and other legumes, mushrooms, orange and tomato juice, and organ meats. A folate deficiency can lead to megaloblastic anemia, as well as an increase in pregnancy loss and birth defects.

The RDA for folate is 400 mcg. Adequate levels of folate reduces homosystine levels in the blood, helps the body produce red blood cells, aids in the metabolism of protein, and aids in cell growth and division. Many breads and cereals are fortified with folic acid, making deficiencies relatively uncommon in developed countries.

A blood test to determine if a patient is deficient in both cobalamin and folate may be indicated if the individual exhibits behavioral or mental changes, such as irritability, depression, or paranoia. a cobalamin and folate deficiency is particularly likely to be a factor in behavior changes in the elderly. Physical symptoms that may indicate a deficiency in both nutrients include unexplained fatigue, weakness, dizziness, or a sore mouth and tongue.


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