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The Differences Between Blood Folate and Serum Folate

When it comes to our health and what we eat, folate is important.

We usually link folate with eating a variety of healthy foods, taking care of yourself during pregnancy, and feeling good in general.

But did you know that folate exists in different forms within our bodies?

Yes, that’s right!. Blood folate and Serum folate are the two forms.

You might have heard people using these words, and you’re wondering what exactly sets them apart from each other.

Although they might sound similar, these two have different functions in our bodies.

In this blog post, we’ll talk about the differences between the two types of folate, their functions, how they’re measured and it’s impact on our health.

Understanding The Basics

First, we need to know what folate is, and why it matters.

Folate is a B-vitamin, also called vitamin B9, that our bodies need for many functions. It helps in making DNA, produces red blood cells, and breaks down certain amino acids.

Folate is good for pregnant women and, it supports the development of the neural tube in babies.

To understand the differences, let’s first get familiar with what folate is all about.

Folate, a water-soluble B-vitamin, exists in various forms, such as dietary folate equivalents (DFE), 5-methyltetrahydrofolate (5-MTHF), and folic acid, among others.

As we ingest folate-rich foods and supplements, our bodies undergo a complex journey of absorption, metabolism, and transportation, leading us to the realms of blood and serum folate.

When we eat foods and take supplements that are rich in folate, our bodies go through a complex process of absorbing, breaking down, and carrying folate around, producing blood folate and serum folate.

Blood Folate vs Serum Folate

When we talk about blood folate, we’re referring to the total amount of folate that is flowing through your bloodstream.

It includes all forms of folate, whether they come from the food we eat or the supplements we take.

Basically, blood folate is like a mixed bag of different folate types flowing through your veins.

Serum folate, on the other hand, refers to the specific form of folate that’s found in your blood plasma.

Serum folate measurements are often used to assess your folate levels and determine if you’re getting enough of this vital nutrient.

But wait, there’s more, the difference doesn’t end there.

Blood folate levels can change based on what you’ve recently eaten, but measuring serum folate gives a better and more consistent indication of your folate levels over a longer time.

So, you could say that serum folate gives you a sneak peek into your folate history.

It’s important to know the difference between blood folate and serum folate, especially if you want to keep track of your nutrient levels.

Now, let’s address these two elephants in the room: blood folate and serum folate.

Blood Folate

Blood folate means checking how much folate is found in your whole blood. It includes the folate inside red blood cells (RBCs) as well as the folate in the liquid part of the blood.

Blood folate levels are typically reported in nanograms per milliliter (ng/mL).

This measurement actually tells you the total amount of folate in your blood sample, giving you a complete picture of your folate status.

Serum Folate

Serum folate is when we measure the amount of folate in the liquid part of your blood, which is called the serum.

Like blood folate, serum folate levels are also reported in ng/mL or nmol/L.

Serum folate levels show how much folate is ready for the body to use, giving us an idea of a person’s current folate status in the short term.

Now, let’s discuss about the key differences between blood folate and serum folate.

Differences Between Blood Folate and Serum Folate

Components Measured

Blood folate measures all the folate in both red blood cells (RBCs) and the serum. It gives us the total folate content.

On the other hand, serum folate measures only the folate in the liquid part of the blood, excluding the folate inside RBCs.


Folate is a sensitive nutrient that can easily break down under certain conditions.

Blood folate, which includes folate in red blood cells (RBCs), is more resistant to degradation compared to serum folate.

Folate inside RBCs is shielded from breakdown, giving us a better idea of our folate status over a longer period.

Serum folate, is the measurement of folate in the liquid portion of blood, is influenced by external factors and may fluctuate more readily.

Diagnostic Purposes

Both blood folate and serum folate tests are used for diagnosing purposes.

Blood folate is helpful in evaluating folate status over a longer period of time, making it useful for detecting ongoing folate deficiencies.

Serum folate, however, is used to assess current folate status and can give insights into recent diet choices or short-term changes in folate levels.

Clinical Interpretation

Understanding blood folate and serum folate levels depends on the reference ranges provided by the lab doing the tests.

If blood folate levels are lower than the normal range, it means there is a deficiency. In such cases, taking extra folate through supplements may be necessary.

Likewise, if serum folate levels are not within the normal range, it could mean either a deficiency or an excess, depending on the actual values obtained.


Even though both blood folate and serum folate gives us information about folate levels, they are different in what they measure, how stable they are, and what they can tell us about our health.

Blood folate measures the total amount of folate in your red blood cells. Serum folate looks at the amount of folate in the liquid part of your blood.

Healthcare professionals use these measurements, along with clinical symptoms and other relevant information, to accurately evaluate how much folate a person has in the body.

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