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[6] [25] At levels only slightly below normal, deficiency can result in fatigue, headaches, feeling faint, rapid breathing, pale skin, numbness or tingling, poor appetite, heartburn, poor balance, difficulty walking, poor reflexes, blurred vision, memory problems, depression, irritability, inattention, cognitive decline, dementia, and even psychosis

This testing is added based on the criteria described above in When to test. In people without Down syndrome, studies have demonstrated that red blood cell folate and serum folate testing provide equivalent data

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A small cooling pouch or insulated case helps maintain temperature stability during transport, even though the medication tolerates room temperature for this extended window