Editorial team. Folate-deficiency anemia. Causes of this type of anemia include: Too little folic acid in your diet Hemolytic anemia Long-term alcoholism Use of certain medicines such as phenytoin [Dilantin], methotrexate, sulfasalazine, triamterene, pyrimethamine, trimethoprim-sulfamethoxazole, and barbiturates The following raise your risk for this type of anemia: Alcoholism Eating overcooked food Poor diet often seen in the poor, the older people, and people who do not eat fresh fruits or vegetables Pregnancy Weight loss diets Folic acid is needed to help a baby in the womb grow properly.
Exams and Tests. The health care provider will perform a physical exam. Tests that may be done include: Complete blood count CBC Red blood cell folate level In rare cases, a bone marrow examination may be done. The goal is to identify and treat the cause of the folate deficiency. Outlook Prognosis. Possible Complications. Other, more severe complications may include: Curly graying hair Increased skin color pigment Infertility Worsening of heart disease or heart failure.
When to Contact a Medical Professional. Furthermore, some people with alcoholism do not eat balanced diets, leading to low nutrient intake. Folate is one of the most important nutrients affected by excessive alcohol use.
Folate deficiency can contribute to the development of alcoholic liver disease. Folic acid is vital during pregnancy, as it is required for the growth and development of the fetus.
Folate is needed to produce red blood cells, so pregnant women experience an increased demand for folate. In fetuses, folate is crucial for the proper development of the neural tube. Folic acid also prevents oral clefts and congenital heart disease.
Ideally, women who are planning to have a baby should begin to supplement with folic acid before they fall pregnant see below. Many elderly people have folic acid deficiencies, because of ageing, poor diets linked to reduced income or absorption problems caused by medication.
Some older people also develop an increased demand for folate, for unknown reasons. Supplementation with B9 for older people may be helpful, and some studies have found that increasing folic acid supplementation in people with low folate levels leads to notable improvements in mood, cognitive function and social functioning.
However, it is not advisable to begin taking folate supplements without consulting a physician. This is important because in elderly people with anemia, supplementing with B9 may cover the effects of B12 deficiencies.
If you are concerned that you or a loved one may have a folate deficiency, you can do a free symptom assessment with Ada. Megaloblasts are large, poorly-formed red blood cells that form in cases of anemia caused by, among others, folate or B12 deficiencies. Megaloblastic anemia is a result of folate deficiency as well as one of the most easily-identified symptoms: sometimes, a deficiency is only identified when anemia presents.
If it results from folate deficiency, this anemia, is treated by taking oral or intravenous folate supplements. Folic acid is very important in the correct development of cells and is crucial for the correct development of fetuses. Pregnant women and women planning to become pregnant should increase their folic acid intake to micrograms a day. Women should increase their intake to 5mg a day if they are or wish to become pregnant and are affected by the following factors: [15] If a women is affected by diabetes, celiac disease, a BMI of more than 30 or is treated with drugs that affect folate absorption, additional supplementation must be considered.
Neural tube defects NTDs can include spina bifida, caudal regressive affecting the lowest part of the spine , and cleft palate. In most cases, folate deficiency is relatively easy to correct. In cases where a deficiency has set in due to poor diet or age, taking a folic acid supplement or modifying the diet is sufficient.
However, if there is an underlying problem, like alcoholic changes to the liver or a drug interaction or condition causing malabsorption, specialised treatment will be required.
The underlying causes of folate deficiency need to be addressed to prevent the problem recurring. Folate deficiency is relatively easily treated in cases where the deficiency is not severe.
In women with megaloblastic anemia, vitamin B12 deficiency must be ruled out before any folic acid treatment can begin. If complications have occurred, or if there is an underlying condition or factor causing the folate deficiency, the affected person may have to be referred to one or more of the following kinds of doctor: [2].
Folate is readily available in many whole foods, such as: [15]. Good to know: Liver should be avoided by pregnant women, due to the high levels of Vitamin A it contains.
Too much vitamin A can cause birth defects. In some countries, such as the United States, South Africa, Chile, Canada and Costa Rica, grain cereal products bread, pasta and breakfast cereals are fortified with folic acid. This is especially the case if the following risk factors are present:. Q:How much folic acid should I take every day? A: The daily need of folic acid differs between adults mcg and people younger than 14 years of age mcg.
It must be emphasized that men, children and women who are not likely to become pregnant obtain a sufficient amount of folate in a healthy diet, containing a wide variety of foods. Pregnant and lactating women need at least micrograms a day and possibly as much as mcg.
Pregnant and lactating women with diabetes, or a family history of neural tube defects, should consult a specialist for optimum supplementation during pregnancy. Q:How much folic acid is too much? Beyond this, there might be adverse effects. Q: Can folic acid deficiency cause diarrhea? Many foods now have additional folate in the form of folic acid, a synthetic version of folate, to prevent deficiency. Nevertheless, supplements are recommended for women who may become pregnant.
Folate is a water-soluble vitamin. A diet low in fresh fruits, vegetables, and fortified cereals is the main cause of folate deficiency. In addition, overcooking your food can sometimes destroy the vitamins.
Diseases that affect absorption in the gastrointestinal tract can cause folate deficiencies. Such diseases include:. Some people have a genetic mutation that hinders their body from properly and efficiently converting dietary or supplemental folate to its usable form, methylfolate. Alcohol interferes with folate absorption. It also increases folate excretion through the urine. Folate deficiency is diagnosed with a blood test. Doctors will often test the folate levels of pregnant women during their prenatal checkups.
At-home testing kits are also available. You can purchase a test kit online from LetsGetChecked here. Treatment involves increasing the dietary intake of folate. You can also take a folate or folic acid supplement. Those with a genetic mutation that affects folate absorption, known as MTHFR , need to take methylated folate in order to avoid deficiency. Folate is frequently combined with other B vitamins in supplements.
These are sometimes called vitamin B complexes. Pregnant women should completely avoid alcohol, and everyone else with a folate deficiency should decrease their alcohol intake.
However, taking folic acid supplements could make depression medications more effective. Some research suggests that taking folic acid before and during early pregnancy could reduce the chance that the baby will have autism.
However, the study results are not conclusive, and more research will be necessary to determine the potential role of folic acid. Doctors may use folic acid to support a methotrexate prescription for rheumatoid arthritis. Methotrexate is an effective medication for this condition, but it may remove folate from the body, causing gastrointestinal symptoms. Most people get enough folate from their diet, and folate deficiency is rare in the United States. That being said, official guidelines recommend that all pregnant women and women who might become pregnant take folic acid.
This is because folic acid is crucial for early fetal development. The spinal cord is one of the first parts of the body to form, and folate deficiency can lead to spinal cord irregularities. Those who are breastfeeding should aim to take around mcg per day. The body absorbs folic acid from supplements and fortified foods better than the folate from naturally occurring foods.
The Office of Dietary Supplements recommend that people get the following dietary folate equivalents DFEs from food or vitamin sources:. It is important to note that folic acid can interact with certain medications and may not be safe for everyone to take. A person should speak to a doctor before taking folic acid if they have any of the following :. Folic acid is present in dietary supplements and fortified foods, including breads, flours, cereals, and grains.
It is also a common addition to B-complex vitamins. Many foods are naturally high in folate. The best sources include :.
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