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Some a lack of folate in your diet diseases or surgeries that affect how your body absorbs folate, including celiac disease, short bowel syndrome, and gastric bypass surgery no stomach acid (achlorhydria) or low stomach acid (hypochlorhydria) drugs that affect folate absorption, including methotrexate and sulfasalazine (Azulfadine) alcohol use disorder pregnancy hemolytic anemia dialysis Consuming too little folate can cause Preventing birth defects and pregnancy complications Folic acid supplements can help to prevent neural tube irregularities, including spina bifida and anencephaly