Folic acid deficiency anemia

Folic acid deficiency also causes macrocytic anemia and the symptoms are similar to those of iron and vitamin B12 deficiency.

Causes of folic acid deficiency anemia

The most common causes of folic acid deficiency are inadequate intake and reduced absorption due to malabsorption disorders or prolonged use of certain medications. Folic acid requirements are raised in liver disease, chronic hemolytic anemias, psoriasis, and with long-term dialysis which can also increase the risk of deficiency. Folic acid stores in the body are limited and a deficiency can develop within a few months.

Folic acid deficiency anemiaFolic acid deficiency anemia due to inadequate intake Poor dietary intake of folic acid-rich foods such as green vegetables is common. Folic acid in food is destroyed by light and heat. Alcohol interferes with folic acid metabolism and alcoholics are at particular risk of folic acid deficiency as they also usually have poor diets.

Folic acid deficiency anemia due to medication use

Folic acid deficiency may occur because of long-term use of certain medications. These include anticonvulsants, barbiturates and oral contraceptives which reduce absorption; the anticancer drug, methotrexate; and some antimicrobial drugs such as trimethoprim and pyrimethamine, which alter the metabolism of folic acid.

Folic acid deficiency anemia in pregnancy

During pregnancy, daily folic acid requirements increase from 180 mcg to 400 mcg. Requirements are also increased during breastfeeding. The raised requirements put women at risk of folic acid deficiency anemia. Folic acid supplements are recommended during pregnancy as they help to reduce this risk and also the risk of neural tube defects.

Diagnosis and treatment of folic acid deficiency anemia

A diagnosis of folic acid deficiency can be confirmed by a laboratory test which measures red blood cell levels of folic acid. Folic acid deficiency anemia is treated with supplements. The usual dose given to replenish tissue stores is 1 mg per day. As previously mentioned, it is important to rule out the possibility of vitamin B12 deficiency anemia before folic acid supplements are given.

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