If your child has been diagnosed with autism, cerebral palsy, developmental delays, or unexplained neurological symptoms — there is a lesser-known but extremely important blood test that may hold some answers. It is called the FRAT test (Folate Receptor Autoantibody Test).
The FRAT test is now available across India, and awareness about it is growing rapidly among paediatric neurologists, developmental paediatricians, and families seeking answers. This guide explains everything you need to know — in simple, easy-to-understand language.
What Is the FRAT Test?
FRAT stands for Folate Receptor Autoantibody Test. It is a specialised blood test that detects autoantibodies (antibodies made by your own immune system) that block or impair folate receptors in the brain.
Folate (Vitamin B9) is essential for brain function. The brain has specific receptors that pull folate from the blood into the cerebrospinal fluid (the fluid surrounding the brain and spinal cord). When the immune system mistakenly produces antibodies that attack these receptors, folate cannot enter the brain properly. This leads to a condition called Cerebral Folate Deficiency (CFD).
What Is Cerebral Folate Deficiency (CFD)?
Cerebral Folate Deficiency is a condition where the brain does not have enough folate even though the blood folate levels may appear normal. It is caused by folate receptor autoantibodies (FRAAs) blocking the folate transport system into the brain.
CFD was first described by researchers in 2005, and since then, hundreds of studies have linked it to a wide range of neurological and developmental conditions in children. According to a landmark study published in the journal Cerebellum, folate receptor autoantibodies were found in a significant proportion of children with autism spectrum disorder and other neurodevelopmental conditions.
Who Should Get the FRAT Test?
The FRAT test is recommended for children and adults with the following conditions or symptoms:
In Children
- Autism Spectrum Disorder (ASD) — Research shows that up to 75% of children with autism may have folate receptor autoantibodies
- Global developmental delay or intellectual disability
- Cerebral palsy of unknown cause
- Seizures or epilepsy that is difficult to control with medication
- Speech and language delay
- Regression in developmental milestones (loss of previously acquired skills)
- Movement disorders or coordination problems
- Low muscle tone (hypotonia)
- Unexplained neurological deterioration
- Rett syndrome or Rett-like symptoms
In Adults
- Treatment-resistant depression or schizophrenia
- Early-onset dementia or cognitive decline
- Peripheral neuropathy (nerve damage) of unknown cause
- Spastic paraplegia
- Women with recurrent miscarriages or neural tube defect pregnancies
How Does the FRAT Test Work?
The FRAT test is a simple blood test. A small sample of blood is collected (usually 2–3 ml), and the sample is tested for two types of folate receptor autoantibodies:
- Blocking autoantibodies (FRAAs-blocking): These directly block the folate receptor, preventing folate from entering the brain
- Binding autoantibodies (FRAAs-binding): These bind to the receptor but may or may not block it
A positive FRAT result means autoantibodies are present and may be causing or contributing to the neurological symptoms your child is experiencing.
What Happens If the FRAT Test Is Positive?
A positive FRAT test is not a final diagnosis — it is a critical piece of information that opens the door to targeted treatment. The standard treatment for FRAT-positive patients is:
- High-dose Leucovorin (Folinic Acid): This is a form of folate that can enter the brain through an alternate pathway, bypassing the blocked folate receptors. Studies have shown significant improvements in language, cognition, behaviour, and social interaction in children with autism and positive FRAT results who received leucovorin treatment.
- Casein-free diet: Dairy proteins (casein) can increase folate receptor antibody levels. Many doctors recommend a casein-free diet alongside leucovorin therapy.
Multiple clinical trials, including research by Dr. Richard Frye at the University of Arkansas and the FRAXA Research Foundation, have demonstrated meaningful improvements in children treated for cerebral folate deficiency.
FRAT Test Availability in India
The FRAT test was previously only available in a handful of labs globally. However, it is now available across India, making it accessible to families in cities like Delhi, Mumbai, Bengaluru, Chennai, Hyderabad, Pune, Kolkata, Chandigarh, Ahmedabad, and more.
At Altus Lab Chandigarh, we offer the FRAT test with pan-India home sample collection and courier-based blood sample submission. Families from any city in India can participate — a courier kit is dispatched to your address, the blood sample is collected by a local phlebotomist, and the sample is shipped to our lab for processing. Learn more about our FRAT Test Kit for Pan India delivery.
How to Book the FRAT Test in India
- Contact Altus Lab via our website at altuslab.in or call our helpline
- Provide details of the patient (age, city, symptoms/diagnosis)
- Choose home collection (local to Chandigarh/Tricity) or Courier Kit (Pan India)
- A trained phlebotomist collects the blood sample
- Sample is processed in our specialised lab
- Receive your FRAT test report with detailed interpretation
FRAT Test Cost in India
The cost of a FRAT test in India varies depending on the laboratory and the location. At Altus Lab, we offer competitive pricing for both local (Chandigarh/Mohali/Panchkula) patients and pan-India courier-based testing. Please contact us directly for current pricing, as costs may change. We believe every family in India deserves access to this important diagnostic test regardless of where they live.
FRAT Test vs Serum Folate Test: What Is the Difference?
Many parents and doctors confuse the FRAT test with a standard folate blood test. Here is why they are completely different:
| Feature | Standard Serum Folate Test | FRAT Test |
|---|---|---|
| What it measures | Folate level in blood | Autoantibodies that block folate receptors in the brain |
| Can it detect CFD? | No — blood folate may be normal even in CFD | Yes — specifically designed to detect CFD |
| Availability in India | Available everywhere | Available at specialised labs like Altus Lab |
| Who needs it? | Routine nutrition check | Children with ASD, developmental delays, neurological symptoms |
Frequently Asked Questions About FRAT Test in India
Is the FRAT test approved in India?
The FRAT test is a laboratory-developed test (LDT) that is offered by specialised diagnostic laboratories in India. It is not a routine test and requires specific expertise for processing and interpretation. Altus Lab follows internationally validated protocols for FRAT testing.
How old does a child need to be for the FRAT test?
The FRAT test can be performed in children as young as 12–18 months. There is no upper age limit — it can also be performed in older children and adults.
Does a positive FRAT test confirm autism?
No. A positive FRAT test does not diagnose autism. Autism is a behavioural diagnosis made by a developmental paediatrician or child psychiatrist. The FRAT test identifies a treatable biological condition (cerebral folate deficiency) that may be contributing to autistic symptoms. Many children with positive FRAT results show improvements with treatment, but results vary.
Is fasting required for the FRAT test?
Yes. The FRAT test requires fasting of at least 4–6 hours before the blood draw. This is important because dairy consumption (milk, cheese, yogurt) can temporarily elevate folate receptor antibody levels and affect test accuracy. A strict casein-free diet for 3–4 days before testing may be recommended by your doctor for the most accurate results.
How long does the FRAT test report take?
The FRAT test is a complex specialised assay. Turnaround time is typically 10–15 working days from the date of sample receipt at the lab. For pan-India courier submissions, please add 2–3 days for transit.
If you have questions about the FRAT test or want to book a test for your child anywhere in India, contact Altus Lab today. You can also read our detailed guide on Cerebral Folate Deficiency and the FRAT Test in Children for a deeper understanding of this condition.