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​ A low folate level may mean that the individual has a deficiency of folate, but the diagnosis depends on the type of test that is conducted as well as on the patient’s diet before the test.[2] Low folate levels can lead to: ​Weakness and tiredness Megaloblastic anemia Painful mouth or tongue Gastrointestinal issues Concentration difficulties Higher levels of homocysteine ​While serum folate is affected by the food eaten immediately before the blood sample is taken, RBC folate can provide information about the long-term folate status of the individual.[2] ​Rising homocysteine levels may also indicate folate deficiency, as folate is needed for converting homocysteine into methionine, even though high levels of homocysteine are also seen in cases of vitamin B12 deficiency, vitamin B6 deficiency, kidney disorders, and other illnesses