Anemia tends to develop among the poor, alcoholics, and pregnant women. Deficiency leads to impaired cell division and to alterations in protein synthesis - the effects which are most pronounced in rapidly growing tissues. Folic acid-deficiency anemia is tired, weak, apathetic, and may have headaches, irregular heartbeats, and labored breathing, a sore tongue, intestinal injury, diarrhea, lack of appetite, weight loss, irritability and forgetfulness. Folic acid is widely distributed in foods. Liver, dark green leafy vegetables, fruit, and yeast are good sources.
Some folic acid is synthesized by bacteria in the intestines.
Cooking destroys some forms of folic acid and it is generally advised that raw fruits and vegetables are included into the diet. Strict vegetarians are prone to be deficient in vitamin B12, because it is obtainable only from animal products but are likely to be well supplied with folic acid because it is abundant in vegetables and fruit. Although it may take years for the new vegan to develop the B12 deficiency, it may be masked by a high folic acid intake. The vegetarian's high intake of folic acid allows red blood cells to develop to normal size and maturity, but does not prevent the nerve damage caused by B12 deficiency. Pregnancy increases the risk and incidence of folic acid deficiency.