Folic acid, also known as vitamin B9, belongs to the group of B vitamins, which are water-soluble (water-soluble). This vitamin participates as a coenzyme in various biochemical reactions (synthesis of purine and pyrimidine, synthesis of methionine, etc.). Folic acid deficiency can lead to a number of health problems: megaloblastic anemia, neural tube defects in fetal development in pregnant women, elevated homocysteine levels leading to other disorders, and so on.
Folate deficiency megaloblastic anemia is caused by a disorder in the process of making “healthy” erythrocytes. In this condition, instead of normal erythrocytes, the bone marrow produces dysfunctional erythrocytes. Because erythrocytes are responsible for transporting oxygen and their production is impaired, anemia occurs.
There are several causes for anemia caused by folic acid deficiency. It can be about:
-Nutritional reasons. Most often, folic acid deficiency is due to inadequate diet (especially the elderly, newborns) or a diet low in folate combined with alcoholism.
-Malabsorption. Certain health conditions such as Crohn’s disease, celiac disease, and tropical sprains can lead to folate deficiency.
-Increased need for folic acid intake. There are health conditions that increase the body’s need for folic acid. They can be physiological (during pregnancy, growth and development at puberty) or pathological (hemolytic anemia, tumor, chronic dialysis, etc.)
-Certain medications. Use of certain medications such as methotrexate, trimethroprim, barbiturates, and oral contraceptives may result in folic acid deficiency.
SYMPTOMS AND SIGNS
The clinical picture of anemia due to folic acid deficiency may include the following symptoms and signs:
-Shortness of breath;
-Palpitations (feeling of a fast or irregular heartbeat);
-Sore tongue with a burning sensation;
Folic acid deficiency anemia has similar symptoms to B12 deficiency anemia. But folic acid deficiency is less likely to cause neuropathy (foot rash, unsafe than) than vitamin B12 deficiency.
The body’s reserves of folic acid are small compared to the daily requirement. Therefore, a folic acid-poor diet for a relatively short time can lead to megaloblastic anemia.
To make a diagnosis, it is necessary to make a detailed physical examination and take a good history. Additionally, a differential blood count and biochemical analysis should be performed. Depending on what led to the folate deficiency, additional clinical trials may be needed.
It is especially important to check for the presence of vitamin B12 deficiency, because there is often a double deficiency, ie. both folic acid and B12.
THERAPY AND PREVENTION
Folic acid deficiency is treated with oral preparations in daily doses prescribed by a doctor. The duration of therapy depends on the cause of the folate deficiency. Preventively, folic acid is recommended for pregnant women and premature babies.
In case of weak but chronic folic acid deficiency, a proper diet rich in this vitamin is advised: spinach, broccoli, citrus fruits, legumes, etc.