Feeling unusually tired? Struggling with memory or concentration issues? If so, your body might be trying to tell you something—and that something could be a folic acid deficiency. A folic acid test is a simple yet powerful diagnostic tool that can reveal a lot about your nutritional and overall health. While often associated with pregnancy, folic acid plays a vital role in everyone’s health, regardless of age or gender. In this guide, you’ll uncover why getting tested matters, what the results mean, and how early detection can protect you from long-term complications.
Whether you’re planning for a baby, experiencing unexplained health symptoms, or just trying to stay ahead of your wellness goals, this test can provide critical insights. Let’s dive deep into the world of folic acid testing, starting with the basics of what folic acid really is and why it deserves your attention.
Understanding Folic Acid – What It Is and Why It Matters
What Is Folic Acid?
Folic acid is the synthetic form of folate, a type of B-vitamin (specifically, B9) that’s essential for cell growth and DNA formation. While folate is naturally present in many foods like leafy greens and legumes, folic acid is the lab-made version used in dietary supplements and food fortification. It’s one of those nutrients your body doesn’t store long-term, which means you need a steady intake to maintain optimal health.
Folic acid plays a foundational role in red blood cell production, healthy brain function, and even emotional well-being. Your body uses it in numerous cellular processes, including methylation, a process critical for gene expression and detoxification. If folic acid levels drop, these functions start to falter, often in subtle but progressive ways.
Role of Folic Acid in the Human Body
The benefits of folic acid go far beyond just pregnancy. Here’s a quick overview of what it does:
- Supports DNA synthesis and repair: Every time your cells divide, folic acid is right there helping your body create and repair genetic material.
- Promotes healthy red blood cells: Deficiency can lead to a type of anemia where red blood cells are abnormally large and ineffective.
- Boosts brain health: Low levels have been linked to mood disorders, memory issues, and even dementia in older adults.
- Reduces risk of birth defects: In pregnant women, folic acid is critical in preventing neural tube defects in the developing fetus.
Without enough folic acid, the body struggles to perform these crucial functions, opening the door to a wide range of physical and mental health problems.
Folic Acid vs. Folate – Know the Difference
These two terms are often used interchangeably, but there are key differences:
- Folate is the natural form found in foods like spinach, avocados, and citrus fruits.
- Folic acid is the synthetic version added to fortified foods or found in supplements.
While both are beneficial, folic acid is generally better absorbed by the body. However, some people have genetic mutations, like MTHFR, that impair their ability to convert folic acid into its active form. This makes testing even more important because it helps identify not just deficiencies but also absorption issues.
Importance of Folic Acid Testing
Why Is a Folic Acid Test Necessary?
You might be wondering, “If I eat healthy, why would I need a test?” The truth is, even a balanced diet doesn’t guarantee you’re absorbing enough folic acid. This test helps pinpoint whether your levels are in the healthy range, too low, or even unusually high.
A folic acid test becomes particularly vital when:
- You have unexplained symptoms like fatigue, irritability, or cognitive decline.
- You’re pregnant or planning to become pregnant.
- You have digestive disorders that impair nutrient absorption.
- You’re taking medications that interfere with folic acid metabolism.
It acts as a critical marker for broader health concerns, offering clues that help doctors dig deeper into underlying issues.
Health Conditions Linked to Folic Acid Deficiency
A lack of folic acid isn’t just a nutrient problem—it can be a sign of more serious health conditions. These include:
- Megaloblastic anemia: Characterized by oversized red blood cells that don’t function properly.
- Neurological issues: From depression and irritability to cognitive decline and memory problems.
- Birth defects: Low folic acid in pregnancy can lead to devastating birth abnormalities like spina bifida.
- Heart disease: Deficiency may increase homocysteine levels, which are linked to cardiovascular problems.
Detecting these conditions early through a simple blood test can help you avoid serious long-term damage.
Who Should Get Tested for Folic Acid Levels?
You don’t need to wait for symptoms to justify a folic acid test. Here’s who should consider it:
- Women of childbearing age: Especially if planning a pregnancy.
- Individuals with chronic digestive disorders: Such as Crohn’s disease or celiac disease.
- People over 60: Older adults are more prone to deficiencies due to reduced absorption.
- Vegans and vegetarians: Plant-based diets may lack sufficient folic acid if not well-balanced.
- Alcohol users: Excessive alcohol can interfere with folic acid absorption.
- Anyone on long-term medication: Drugs like methotrexate, anticonvulsants, or even birth control can reduce folic acid levels.
If you fall into any of these categories, a folic acid test can be a smart, preventive step.
Signs and Symptoms That Indicate You Need a Folic Acid Test
Physical Symptoms of Folic Acid Deficiency
Sometimes, your body whispers before it screams. The physical symptoms of folic acid deficiency can be subtle at first but gradually intensify if left unchecked. Some of the earliest signs may include general fatigue or feeling unusually tired after minimal effort. This happens because folic acid is essential for producing healthy red blood cells, and a deficiency can lead to anemia, causing decreased oxygen delivery throughout the body.
Other physical signs to look out for include:
- Pale skin or paleness in the lining of the eyes
- Shortness of breath, even after light activity
- Frequent headaches or dizziness
- Weakness in muscles
- Sore or swollen tongue (a condition called glossitis)
- Mouth sores or ulcers
Many of these symptoms are often misattributed to stress, poor sleep, or seasonal changes. That’s why a folic acid blood test is key—it provides clarity on what’s really going on inside your body. If you’re experiencing any of these, don’t wait. Testing can bring peace of mind or reveal the need for immediate action.
Neurological Symptoms Caused by Low Folic Acid
Low folic acid doesn’t just affect your physical energy; it also plays a direct role in your mental and neurological health. In fact, a deficiency can cause changes in your brain chemistry that mimic serious neurological disorders. This is particularly concerning because it’s often overlooked until symptoms become severe.
Some neurological signs of folic acid deficiency include:
- Memory problems
- Difficulty concentrating
- Irritability or mood swings
- Depression and anxiety
- Tingling or numbness in hands and feet
In extreme cases, a long-term deficiency can lead to confusion, cognitive decline, or even psychosis—especially in older adults. This makes folic acid testing a valuable screening tool for individuals experiencing unexplained mental health or cognitive symptoms. If you’re noticing a change in how you think, feel, or process information, it’s worth investigating your folic acid levels.
Risks in Pregnant Women Due to Folic Acid Deficiency
For women, especially those who are pregnant or trying to conceive, folic acid is non-negotiable. It’s one of the most critical nutrients during pregnancy, particularly in the first trimester when the baby’s brain and spinal cord are forming. A deficiency during this stage can lead to neural tube defects (NTDs), including spina bifida and anencephaly.
Here are other pregnancy risks associated with low folic acid:
- Premature birth
- Low birth weight
- Placental abruption
- Cleft lip and palate
- Developmental delays
Even if you’re not pregnant, if there’s a chance you might become pregnant, doctors recommend getting tested and ensuring optimal folic acid levels beforehand. Since many birth defects occur within the first 4 weeks of pregnancy—often before a woman knows she’s pregnant—proactive testing and supplementation are crucial.
How the Folic Acid Test Works
Types of Folic Acid Tests Available
When it comes to checking your folic acid status, there are generally two main types of tests:
- Serum folate test – This measures the amount of folate in your blood at the time of the test. It reflects recent folic acid intake and is commonly used in clinical settings.
- Red blood cell (RBC) folate test – This test measures folate levels inside your red blood cells and provides a better indication of your long-term folic acid status.
Doctors often recommend both if there’s a need for a more comprehensive picture. The RBC folate test is particularly useful if you have symptoms but your serum test comes back normal.
What to Expect During the Test Procedure
The folic acid test is simple and fast—no need for any fancy equipment or invasive procedures. Here’s what typically happens:
- A healthcare professional draws a small sample of blood from a vein, usually in your arm.
- The sample is sent to a lab where your folate levels are measured.
- Results are typically available within 24 to 72 hours depending on the facility.
There’s minimal discomfort involved—just a quick needle stick—and you can go about your day immediately afterward. No downtime, no stress.
Preparing for the Folic Acid Blood Test
To get the most accurate results, your doctor may ask you to fast for 8–12 hours before the test, especially if other nutrient levels (like vitamin B12) are being checked simultaneously. It’s also a good idea to:
- Avoid folic acid supplements for at least 24 hours prior, unless instructed otherwise.
- Inform your doctor about all medications and supplements you’re taking.
- Stay hydrated, which can help make blood draw easier.
Being honest about your diet, lifestyle, and symptoms helps your healthcare provider interpret the test results more effectively and recommend the right course of action.
Understanding Folic Acid Test Results
What Is Considered a Normal Folic Acid Level?
Interpreting your folic acid test results is crucial for understanding where you stand health-wise. Here’s a general guide for serum folate levels (though values may vary slightly by lab):
- Normal range: 2.7 to 17.0 nanograms per milliliter (ng/mL)
- Low: Less than 2.7 ng/mL
- High: Above 17.0 ng/mL
If you undergo an RBC folate test, normal values usually range between 140 to 628 nanograms per milliliter (ng/mL), depending on the lab’s standards.
It’s important to note that a “normal” result doesn’t always mean “optimal”—especially if you’re experiencing symptoms. Some individuals might require higher folate levels based on their health conditions or life stage (e.g., pregnancy, chronic illness, advanced age).
Low Folic Acid Level – What It Means
If your results indicate a folic acid deficiency, it’s a sign that your body isn’t getting or absorbing enough folate. Possible causes include:
- Poor diet lacking in leafy greens and legumes
- Malabsorption disorders (e.g., celiac, Crohn’s)
- Overuse of alcohol
- Medication side effects
Low levels can lead to:
- Anemia
- Cognitive issues
- Fatigue
- Mood disorders
- Birth defects in pregnancies
Getting to the root of the deficiency is the next step. Your doctor might suggest dietary changes, supplementation, or further testing to check for underlying health issues.
High Folic Acid Levels – Is It a Concern?
Yes, there is such a thing as too much folic acid—especially when it’s from supplements rather than food. Elevated folic acid levels may mask a vitamin B12 deficiency, which can lead to irreversible neurological damage if left untreated.
Other potential causes of high folic acid levels include:
- Over-supplementation
- Liver or kidney disorders affecting nutrient metabolism
- Certain cancers that increase folate uptake
While high folate levels from food sources aren’t dangerous, consistently elevated levels from synthetic folic acid can be. This is why testing is critical before blindly taking supplements long-term.
Causes of Abnormal Folic Acid Levels
Dietary Causes of Low Folic Acid
Your diet plays a pivotal role in maintaining healthy folic acid levels. A folate-rich diet includes plenty of green vegetables, fruits, beans, and fortified grains. Unfortunately, modern eating habits often lack these essentials, leading to nutritional gaps. If you frequently consume processed foods, skip vegetables, or rely heavily on fast food, you’re at a higher risk of folic acid deficiency.
Here are some common dietary habits that cause low folic acid:
- Inadequate intake of leafy greens like spinach, kale, and romaine
- Minimal consumption of fruits such as oranges, bananas, and berries
- Skipping breakfast, which often includes fortified cereals
- Low-protein diets, especially in vegans who don’t balance their food groups properly
- Poor meal planning or restrictive diets (like low-carb or keto) without supplementation
Folate is water-soluble, meaning it isn’t stored in large quantities in your body. So, if your diet lacks it even for a few weeks, you can start to experience symptoms. Fortunately, with the right dietary changes and a little planning, you can turn it around quickly.
Medical Conditions That Affect Folic Acid Absorption
Sometimes, even if you eat right, your body might not absorb folic acid effectively. Several medical conditions interfere with the absorption of folate in the small intestine, and these often go undiagnosed for years. The result? Chronic deficiency that leads to a range of health problems.
Common conditions that affect folic acid absorption include:
- Celiac disease – Damages the intestinal lining, reducing nutrient absorption.
- Crohn’s disease – Causes inflammation that limits vitamin uptake.
- Irritable Bowel Syndrome (IBS) – May lead to malabsorption indirectly due to gut dysfunction.
- Chronic diarrhea – Causes essential nutrients to pass through before being absorbed.
- Gastric bypass surgery – Alters the digestive tract, limiting folate absorption.
If you have a history of these conditions or persistent digestive issues, folic acid testing should be part of your routine care. Identifying the root cause early can prevent complications.
Medications That Lower Folic Acid Levels
Certain prescription medications interfere with folic acid metabolism or block its absorption altogether. If you’ve been prescribed long-term treatments for chronic conditions, there’s a chance they may be impacting your folate levels without you realizing it.
Medications that commonly reduce folic acid levels include:
- Anticonvulsants (used for epilepsy or mood disorders)
- Methotrexate (used for autoimmune diseases and cancer)
- Sulfasalazine (used for ulcerative colitis and rheumatoid arthritis)
- Diuretics (used to treat high blood pressure or heart failure)
- Metformin (for type 2 diabetes)
- Oral contraceptives
If you’re on any of these, periodic folic acid tests are crucial. Your doctor may recommend a folic acid supplement to counterbalance the depletion caused by these medications.
Health Risks of Untreated Folic Acid Deficiency
Risk of Anemia and Fatigue
One of the earliest and most obvious consequences of low folic acid is megaloblastic anemia. This form of anemia occurs when the body can’t produce enough healthy red blood cells due to inadequate folate. Red blood cells grow too large and can’t carry oxygen effectively, leaving you exhausted, weak, and breathless.
Symptoms of folate-deficiency anemia include:
- Chronic fatigue
- Pale skin
- Shortness of breath
- Heart palpitations
- Trouble focusing
If untreated, anemia can progress and strain your cardiovascular system, leading to further complications. A simple folic acid test can catch this early and help you get the right treatment before it affects your daily life.
Mental Health Impact of Folic Acid Deficiency
Folic acid isn’t just about physical health—it plays a major role in brain chemistry. Folate helps in the production of neurotransmitters like serotonin and dopamine, which regulate your mood and cognitive function. Deficiency in folic acid has been linked to mental health disorders, including depression and anxiety.
Some mental health effects of low folic acid include:
- Low mood or depressive episodes
- Memory problems or brain fog
- Trouble sleeping
- Increased irritability
- Worsening of existing psychiatric symptoms
What’s alarming is that folic acid deficiency often mimics psychiatric illnesses. Many people are misdiagnosed or given medications for depression when the root cause might simply be a lack of folate. This is another reason why testing is vital—it helps rule out nutritional deficiencies before jumping to more invasive treatments.
Fetal Development Risks in Pregnancy
Folic acid is essential for cell division and fetal neural tube development. When pregnant women have insufficient folate levels, the baby is at risk for severe congenital disabilities. That’s why folic acid supplements and tests are strongly recommended both before and during pregnancy.
Some fetal complications linked to folate deficiency include:
- Neural tube defects (NTDs): Such as spina bifida and anencephaly
- Cleft palate and lip
- Low birth weight
- Increased risk of miscarriage or stillbirth
- Delayed physical or mental development
Doctors typically advise women to start folic acid supplementation at least one month before trying to conceive. However, testing provides a clearer picture of whether your body is actually absorbing enough and can help prevent avoidable tragedies.
Benefits of Early Detection Through Folic Acid Testing
Preventing Long-Term Health Issues
Getting your folic acid levels checked early can prevent a host of chronic health issues that might otherwise go undiagnosed for months or even years. Many health conditions—from cardiovascular disease to depression—are linked to low folate. Detecting the issue early means you can correct it before irreversible damage is done.
Some long-term risks that can be avoided include:
- Stroke
- Heart disease due to high homocysteine levels
- Chronic fatigue and work impairment
- Infertility or pregnancy complications
- Irreversible nerve damage
With just a small blood sample, folic acid testing gives you access to one of the most important preventive tools in modern health care.
Improved Pregnancy Outcomes
One of the best-documented benefits of folic acid testing is its role in improving pregnancy outcomes. Early detection allows for targeted supplementation that drastically reduces the risk of fetal abnormalities and ensures the mother remains healthy throughout gestation.
Benefits include:
- Reduced risk of miscarriage
- Lower incidence of neural tube defects
- Fewer complications during labor
- Better nutrient support for fetal growth
Testing also enables healthcare providers to monitor changes throughout pregnancy and adjust supplementation as needed.
Enhanced Energy and Mental Clarity
If you’ve been battling unexplained tiredness, brain fog, or mood swings, a folic acid deficiency could be the missing piece of the puzzle. Correcting this deficiency often results in noticeable improvements in:
- Energy levels
- Ability to focus
- Sleep quality
- Emotional resilience
Many people report feeling like a fog has lifted once they get their folic acid levels back to normal. It’s a simple fix with powerful benefits for both body and mind.
Treatment and Management of Folic Acid Deficiency
Dietary Recommendations for Boosting Folic Acid
Reversing a folic acid deficiency starts in the kitchen. Eating a folate-rich diet is one of the most effective ways to restore your levels naturally. Foods rich in natural folate include:
- Dark leafy greens (spinach, kale, romaine)
- Legumes (beans, lentils, chickpeas)
- Citrus fruits (oranges, lemons, grapefruits)
- Asparagus
- Broccoli
- Beets
- Brussels sprouts
- Avocados
Aim to include at least one folate-rich food in every meal. Combine this with good hydration and balanced protein intake for best results.
Folic Acid Supplements – Dosage and Benefits
When diet alone isn’t enough, supplements are a reliable way to boost folic acid. Doctors usually recommend 400 to 800 micrograms (mcg) per day, depending on your age, gender, and health status. Pregnant women may need up to 1,000 mcg/day.
Benefits of folic acid supplements:
- Faster recovery from deficiency
- Protection against neural tube defects during pregnancy
- Improved mood and cognitive clarity
- Reduced risk of heart disease and stroke
Be cautious with high-dose supplementation without supervision. Taking too much folic acid can mask other deficiencies like vitamin B12, so always consult a healthcare provider before starting.
Monitoring and Retesting Your Levels
Once you’ve begun treatment, retesting is important to ensure your levels are improving. Depending on your initial results and treatment method, doctors may recommend testing every:
- 4 to 6 weeks for moderate to severe deficiency
- 3 to 6 months for maintenance monitoring
Ongoing tests help refine your treatment plan and confirm that your body is absorbing nutrients properly. It also gives peace of mind that you’re on the right track.
Lifestyle Tips for Maintaining Healthy Folic Acid Levels
Foods Rich in Natural Folate
Want to boost your folic acid naturally? It all starts with your plate. Including folate-dense foods in your daily meals not only prevents deficiency but also enhances your overall vitality. The best part? These foods are as delicious as they are nutritious.
Here are some of the top folate-rich foods you should include in your diet:
- Dark leafy greens: Spinach, kale, collard greens, and Swiss chard are excellent sources.
- Legumes: Lentils, black beans, and chickpeas are fiber- and folate-packed.
- Fruits: Oranges, papayas, bananas, and avocados provide significant amounts.
- Vegetables: Asparagus, broccoli, Brussels sprouts, and beets are folate champions.
- Fortified grains: Breakfast cereals, bread, and pasta often have added folic acid.
- Nuts and seeds: Sunflower seeds, peanuts, and almonds are great folate boosters.
Aim for a colorful, diverse plate at every meal. The more vibrant your diet, the more likely you’re getting the nutrients your body needs—including folate.
Cooking Methods That Preserve Folate
Here’s a tip you might not know: folate is heat-sensitive, meaning that how you cook your food can impact how much folate you actually consume. Boiling, for instance, can destroy up to 50% of folate content in vegetables.
To maximize folate retention:
- Steam instead of boil – It keeps more nutrients intact.
- Microwave with minimal water – Preserves vitamins better than traditional methods.
- Eat raw when possible – Leafy greens and fruits retain their full nutrient profiles uncooked.
- Avoid overcooking – Keep vegetables firm and slightly crisp.
Small tweaks in your cooking routine can lead to big changes in how well your body absorbs and utilizes folic acid.
Healthy Habits That Support Nutrient Absorption
It’s not just what you eat, but how your body processes it. Certain habits can either help or hinder folic acid absorption.
Support optimal folate uptake with these practices:
- Limit alcohol: Excessive drinking impairs folic acid absorption and depletes reserves.
- Avoid smoking: Tobacco use reduces nutrient absorption and increases oxidative stress.
- Manage gut health: Probiotics and fiber-rich foods keep your digestive system functioning efficiently.
- Balance your microbiome: A healthy gut improves vitamin B absorption.
- Get regular exercise: Physical activity supports overall metabolic health, including nutrient transport.
By maintaining these healthy lifestyle habits, you can improve how your body uses folate and keep deficiency at bay.
Folic Acid Testing and Your Doctor’s Role
When to Consult a Healthcare Provider
While folic acid testing might seem straightforward, timing it right can make all the difference. You should consult your doctor for a test if you’re experiencing:
- Unexplained fatigue or weakness
- Mood changes or memory lapses
- Difficulty getting pregnant or maintaining a pregnancy
- A chronic digestive condition
- Long-term medication use known to lower folate levels
Also, make it part of your routine blood work if you fall into a high-risk category like older adults, vegetarians, or individuals recovering from surgery.
Don’t self-diagnose—partner with a healthcare provider who can help interpret symptoms in the full context of your health history.
Questions to Ask About Your Folic Acid Test
Being proactive with your health means asking the right questions. When discussing folic acid testing with your doctor, consider asking:
- What kind of test do I need—serum or RBC folate?
- Should I fast before the test?
- Will you also check vitamin B12 and homocysteine levels?
- If my levels are low, what’s the likely cause?
- How often should I retest after beginning treatment?
The more informed you are, the better decisions you can make about your health journey.
Working with Your Doctor on a Treatment Plan
A folic acid test is just the beginning. Once the results are in, your doctor will guide you through a personalized treatment plan that may include:
- Dietary changes and meal planning
- Prescribed or over-the-counter supplements
- Addressing any underlying medical conditions
- Follow-up tests to monitor improvement
Don’t hesitate to ask for a detailed explanation of your results and next steps. A good doctor will involve you in the process, making sure you understand and agree with the treatment approach.
Myths and Misconceptions About Folic Acid Testing
Is It Only for Pregnant Women?
Absolutely not! While folic acid is often discussed in the context of pregnancy, it’s vital for everyone—men and women, young and old. Men need folate for sperm health and heart function. Children require it for growth. Adults need it for brain health and cell repair.
The misconception that folic acid testing is only for expectant mothers has caused many people to ignore symptoms that point to a deficiency. In reality, anyone can benefit from folic acid testing.
Can You Get Too Much Folic Acid?
Yes, particularly from supplements and fortified foods. While it’s rare to overdose on folate from natural sources like leafy greens, excess folic acid from pills and fortified foods can mask a vitamin B12 deficiency, which is a serious issue.
Symptoms of too much folic acid may include:
- Gastrointestinal distress
- Insomnia
- Skin reactions
- Mental confusion (especially if B12 is also low)
Stick to recommended dosages unless otherwise advised by your doctor, and always test before supplementing.
Is Testing Really Necessary If You Feel Fine?
Yes—and here’s why: deficiencies can be silent. Just because you feel okay now doesn’t mean there isn’t a problem brewing beneath the surface. Many nutrient deficiencies, including folic acid, take time to produce obvious symptoms. By the time you notice something’s wrong, the deficiency may already be affecting your organs, energy levels, or brain function.
Think of a folic acid test like a routine oil check for your car. You don’t wait for your engine to fail to check the oil—same principle here.
Conclusion – Taking Charge of Your Health with a Folic Acid Test
Folic acid may be a small nutrient, but it plays a gigantic role in your health. From producing healthy red blood cells to supporting brain function and fetal development, its impact spans across every stage of life. A folic acid test isn’t just for pregnant women or people with obvious symptoms—it’s a vital screening tool that everyone should consider.
When caught early, folic acid deficiency is highly treatable through dietary adjustments, supplements, and lifestyle changes. But left unchecked, it can lead to serious consequences like anemia, cognitive decline, and birth defects.
So, if you’ve been putting off that blood test, now’s the time to take action. Partner with your healthcare provider, understand your results, and take control of your well-being—one simple test could change everything.
FAQs
Can I take folic acid supplements without testing?
Yes, but it’s always better to test first. Unnecessary supplementation can mask other issues, especially vitamin B12 deficiency. Testing gives a clearer picture and ensures safe, effective treatment.
How often should I get a folic acid test?
If you’re in a high-risk group (e.g., pregnant, over 60, chronic illness), you may need it annually or even more frequently. For others, once every few years or when symptoms appear may be sufficient.
Are there risks in testing folic acid levels?
The test itself is very safe—just a standard blood draw. However, interpreting results without context can lead to incorrect self-treatment. Always consult with your doctor.
What is the cost of a folic acid test?
Prices vary depending on location, lab, and insurance coverage, but typically range from $30 to $100. Some health packages include folic acid tests as part of a full vitamin panel.
How long does it take to get folic acid test results?
Most results are available within 1 to 3 days. Some labs offer same-day results, especially if you’re using a wellness clinic or private testing center.
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