Folic acid deficiency anemia

Folate deficiency

Basic Information

Description

Anemia caused by a deficiency of folic acid. It is often accompanied by iron-deficiency anemia.

Frequent signs and symptoms

  • Fatigue and weakness.
  • Red, sore tongue.
  • Paleness.
  • Shortness of breath.
  • Nausea, vomiting and diarrhea (rare).

Causes

  • Complication of pregnancy, when the body needs 8 times more folic acid than usual.
  • Inadequate intake or absorption of foods with a high folic-acid content, such as meat, poultry, fish, cheese, milk, eggs, green vegetables, yeast and mushrooms.
  • Alcoholism.
  • Overcooking foods, which destroys folic acid.
  • Deficiency of vitamin B-12 or vitamin C.

Risk increases with

  • Adults over 60, especially those who have poor nutrition.
  • Pregnancy.
  • Illness, such as tropical sprue, psoriasis, acne rosacea, eczema or dermatitis herpetiformis.
  • Fad diets or general poor nutrition, especially vitamin- C deficiency.
  • Surgical removal of the stomach.
  • Smoking, which decreases vitamin C absorption. Vitamin C is necessary for folic-acid absorption.
  • Use of certain drugs, such as oral contraceptives, anticonvulsants, methotrexate, triamterene or sulfasalazine.

Preventive measures

  • Don't drink alcohol.
  • Have regular medical checkups during pregnancy. Take prenatal vitamin supplements, if they are prescribed.
  • Eat well. Include fresh vegetables, meat and other animal proteins. Avoid fad diets. Don't overcook food.
  • Don't smoke. Smoking increases vitamin requirements.

Expected outcomes

Usually curable in 3 weeks with an adequate folic-acid intake.

Possible complications

  • Infertility.
  • Increased susceptibility to infection.
  • Congestive heart failure (severe cases only).
  • Folic-acid deficiency can also increase the risk for conceiving a child with a neural tube defect.

Treatment of Folic acid deficiency anemia

General measures

  • Diagnostic tests may include laboratory blood studies, a Schilling test to measure vitamin B-12 levels and a therapeutic trial of vitamin B-12.
  • Treatment consists mainly of folic acid supplements and elimination of contributing causes.
  • If you smoke, stop smoking.
  • If you take oral contraceptives, consider using another form of contraception.

Medications

  • Folic-acid supplements.
  • Iron supplements to take orally.

Activity

Anemia does cause fatigue. Schedule regular rest periods until you are able to resume normal activity.

Diet

No special diet. Eat foods daily that are high in folic acid. The liver can store folic acid for a limited time only. Foods include asparagus spears, beef liver, broccoli spears, collards (cooked), mushrooms, oatmeal, peanut butter, red beans, and wheat germ.

Notify your physician if

  • You or a family member has symptoms of anemia.
  • Symptoms don't improve in 2 weeks, despite treatment.
  • Symptoms of infection (fever, chills and muscle aches) occur during treatment.

Last updated 7 August 2011


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