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Folate deficiency

Deficiency - folic acid; Folic acid deficiency

 

Folate deficiency means you have a lower-than-normal amount of folic acid , a type of vitamin B, in your blood.

Causes

 

Folic acid (vitamin B9) works with vitamin B12 and vitamin C to help the body break down, use, and make new proteins. The vitamin helps form red and white blood cells. It also helps produce DNA, the building block of the human body, which carries genetic information.

Folic acid is a water-soluble type of vitamin B. This means it is not stored in the fat tissues of the body. Leftover amounts of the vitamin leave the body through the urine.

Because folate is not stored in the body in large amounts, your blood levels will get low after only a few weeks of eating a diet low in folate. Folate is found in green leafy vegetables and liver.

Contributors to folate deficiency include:

  • Diseases in which folic acid is not well absorbed in the digestive system (such as Celiac disease or Crohn disease )
  • Drinking too much alcohol
  • Eating overcooked fruits and vegetables. Folate can be easily destroyed by heat.
  • Hemolytic anemia
  • Certain medicines (such as phenytoin, sulfasalazine, or trimethoprim-sulfamethoxazole)
  • Eating an unhealthy diet that does not include enough fruits and vegetables
  • Kidney dialysis

 

Symptoms

 

Folic acid deficiency may cause:

  • Fatigue, irritability, or diarrhea
  • Poor growth
  • Smooth and tender tongue

 

Exams and Tests

 

Folate deficiency can be diagnosed with a blood test . Pregnant women commonly have this blood test at prenatal checkups.

 

Possible Complications

 

Complications include:

  • Anemia (low red blood cell count)
  • Low levels of white blood cells and platelets (in severe cases)

In folate-deficiency anemia , the red blood cells are abnormally large (megaloblastic).

Pregnant women need to get enough folic acid. The vitamin is important to the growth of the fetus's spinal cord and brain. Folic acid deficiency can cause severe birth defects known as neural tube defects . The Recommended Dietary Allowance (RDA) for folate during pregnancy is 600 micrograms/day.

 

Prevention

 

The best way to get vitamins your body needs is to eat a balanced diet . Most people in the United States eat enough folic acid because it is plentiful in the food supply.

Folate occurs naturally in the following foods:

  • Beans and legumes
  • Citrus fruits and juices
  • Dark green leafy vegetables such as spinach, asparagus, and broccoli
  • Liver
  • Mushrooms
  • Poultry, pork, and shellfish
  • Wheat bran and other whole grains

The Institute of Medicine Food and Nutrition Board recommends that adults get 400 micrograms of folate daily. Women who may become pregnant should take folic acid supplements to ensure that they get enough each day.

Specific recommendations depend on a person's age, gender, and other factors (such as pregnancy and lactation). Many foods, such as fortified breakfast cereals, now have extra folic acid added to help prevent birth defects.

 

 

Open References

References

Antony AC. Megaloblastic anemias. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 164.

Antony AC. Megaloblastic anemias. In: Hoffman R, Benz EJ Jr, Silberstein LE, Heslop HE, Weitz JI, eds. Hematology: Basic Principles and Practice . 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 37.

 
  • First trimester of pregnancy

    First trimester of pregnancy - illustration

    The first trimester of pregnancy is the first three months after conception. Signs of early pregnancy are missed menstrual periods, fatigue, breast enlargement, abdominal distention, and nausea. During this period of time all organ development takes place so the fetus is most susceptible to damage from toxins, drugs, and infections.

    First trimester of pregnancy

    illustration

  • Folic acid

    Folic acid - illustration

    Studies show that an increase in the mother's dietary folic acid before conception and during the first month of pregnancy reduces the risk of having a child with a neural tube defect. The recommendation is that women of childbearing years take a daily folic acid supplement.

    Folic acid

    illustration

  • Early weeks of pregnancy

    Early weeks of pregnancy - illustration

    The first trimester of a pregnancy is a time of incredible growth and development. A 7-week fetus will have begun to develop all essential organs.

    Early weeks of pregnancy

    illustration

    • First trimester of pregnancy

      First trimester of pregnancy - illustration

      The first trimester of pregnancy is the first three months after conception. Signs of early pregnancy are missed menstrual periods, fatigue, breast enlargement, abdominal distention, and nausea. During this period of time all organ development takes place so the fetus is most susceptible to damage from toxins, drugs, and infections.

      First trimester of pregnancy

      illustration

    • Folic acid

      Folic acid - illustration

      Studies show that an increase in the mother's dietary folic acid before conception and during the first month of pregnancy reduces the risk of having a child with a neural tube defect. The recommendation is that women of childbearing years take a daily folic acid supplement.

      Folic acid

      illustration

    • Early weeks of pregnancy

      Early weeks of pregnancy - illustration

      The first trimester of a pregnancy is a time of incredible growth and development. A 7-week fetus will have begun to develop all essential organs.

      Early weeks of pregnancy

      illustration

    A Closer Look

     

      Tests for Folate deficiency

       
         

        Review Date: 7/14/2015

        Reviewed By: Emily Wax, RD, The Brooklyn Hospital Center, Brooklyn, NY. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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