What is the FRAT® Test?
The FRAT® (Folate Receptor Antibody Test) is a patented diagnostic blood test that screens for Folate Receptor Alpha Autoantibodies (FRAAs) that disrupt folate transport into the brain and body by binding to the folate receptor alpha (FRα).
FRα is a protein responsible for transporting folate (vitamin B9) across cell membranes. Folate is vital for healthy cell growth and function, supporting the development and maintenance of tissues and organs.
There are two main types of Folate Receptor Alpha Autoantibodies (FRAAs):
- Blocking FRAAs – that directly block the folate binding site and interfere with the proper absorption of folate into critical tissues such as the brain potentially leading to neurological issues and developmental delays, and have been linked to conditions such as Autism Spectrum Disorders and Cerebral Folate Deficiency Syndrome.
- Binding FRAAs – that bind to a different part of the receptor and can cause inflammation
How do I get the FRAT® test through Neuro Voyager?
At Neuro Voyager, we follow a structured clinical pathway to ensure appropriate evaluation and support:
- Referral letter required
- A referral from your GP, General Paediatrician, or specialist is required. This ensures we receive a complete clinical history before proceeding.
- Consultation appointment scheduled
- Once the referral is received, our team will organise a consultation with one of our specialists to assess symptoms, medical history, and suitability for FRAT® testing.
- FRAT® ordered after consultant review
- If clinically appropriate, the consultant will order the FRAT® test following the appointment. Testing is not performed automatically without this review.
- Results & Follow-Up
- Results are typically available within 6-8 weeks. A follow-up consultation will be arranged to discuss findings and potential treatment options.
Can I get the test without a doctor’s referral?
No. Our clinic requires a referral from your current doctor and then one of our consultants will assess if your child is a candidate before any testing is ordered. This is to ensure clinical appropriateness and provide comprehensive care.
Who is a candidate for FRAT®?
FRAT® may be recommended for:
- Children with autism spectrum disorder or developmental delays
- Individuals with neurological symptoms of unclear origin
- Children or young adults with seizures, hypotonia, or motor coordination issues
- Siblings or family members of affected individuals.
How is the FRAT® Test performed?
The FRAT® test is a simple test where a blood sample (typically 2 to 4 ml of blood) is collected and sent for analysis.
The test uses an immunoassay technique (like ELISA or RIA) to detect and measure the concentration of the two types of autoantibodies; blocking (preventing folate from binding to FRα) and binding (attach to FRα and may trigger immune-mediated damage), and can help to provide comprehensive results for assessing a child’s neurological condition.
If the FRAT® test detects autoantibodies, a follow-up consultation will be arranged to discuss treatment options, which may involve using alternative folate forms that bypass the blocked transport system or making dietary adjustments.
Do you handle the blood draw and shipping of the FRAT® sample?
Yes. We manage the entire process in-house, including the blood draw and secure shipping of the sample to the testing laboratory. This ensures correct handling, reduces delays, and provides a seamless experience for our patients.
You do not need to arrange any part of the testing process externally; everything is taken care of by our clinical team during your visit.
Is fasting required for the FRAT® test?
Fasting is not required, but patients should avoid folate supplements for at least 48 hours prior to testing.
How long does it take to get FRAT® test results?
Results typically take 6-8 weeks.
What do the results mean?
- Positive: For blocking or binding antibodies. Suggests the presence of folate receptor autoimmunity. This may warrant treatment or further evaluation.
- Negative: No autoantibodies detected. Other causes of symptoms may be considered.
What happens after a positive result?
If your FRAT® test is positive, you will be followed up directly by the requesting consultant, who will explain the results in detail and discuss the next steps.
They can prescribe the appropriate treatment, typically high dose folinic acid (leucovorin), immediately and manage your care entirely in-house. This means there is no need for external referrals or delays.
IMPORTANT INFORMATION FOR FAMILIES
Folate Receptor Antibody Testing (FRAT) is not a treatment and not a laboratory service provided by Neuro Voyager.
Neuro Voyager is a clinical medical practice. Our role in relation to FRAT® is limited to:
- specialist clinical assessment and case selection,
- advising whether FRAT® is clinically appropriate,
- coordinating blood sampling where requested,
- clinical interpretation of results once available,
- and advising on management options where relevant.
We do not operate a laboratory and do not perform the FRAT® assay ourselves. Laboratory analysis is carried out by independent third-party laboratories, which are selected based on availability and clinical suitability. Laboratory fees, courier costs, and any medication costs are separate from Neuro Voyager consultation fees and are payable directly to the relevant provider.
Fees and scope
- Fees charged by Neuro Voyager relate only to the medical consultation, assessment, and professional advice provided by a GMC-registered consultant.
- Booking a consultation does not guarantee that FRAT® will be recommended, arranged, or appropriate.
- A consultation may conclude that FRAT® is not indicated.
Important clarifications
- FRAT® is not a screening test and is not required for all children with developmental or neurological concerns.
- The presence or absence of folate receptor antibodies does not in itself establish a diagnosis.
- Any discussion of supplementation or treatment is individualised, based on clinical context, and remains the responsibility of the prescribing clinician.
- Families are not obliged to proceed with any test or treatment discussed.
Choice and alternatives
Families are free to:
- seek testing or advice elsewhere,
- discuss investigations with their NHS GP or NHS specialists,
- or decline testing altogether.
Choosing not to proceed with FRAT® does not affect access to other medical advice or care.
Everything from diagnosis to treatment initiation is handled by our experienced clinical team, ensuring continuity of care and a streamlined, personalised treatment plan tailored to your needs.