Folate deficiency

Folate deficiency
Folic acid, a precursor of active B9
SpecialtyEndocrinology
SymptomsFeeling tired, shortness of breath, changes in the color of the skin or hair, irritability[1]
ComplicationsMegaloblastic anemia[1]
Diagnostic methodBlood tests[1]
TreatmentFolic acid supplementation[1]
FrequencyVery rare (countries with fortification programs)[2]

Folate deficiency, also known as vitamin B9 deficiency, is a low level of folate and derivatives in the body.[1] This may result in megaloblastic anemia in which red blood cells become abnormally large, and folate deficiency anemia is the term given for this medical condition.[3] Signs of folate deficiency are often subtle.[4] Symptoms may include fatigue, heart palpitations, shortness of breath, feeling faint, open sores on the tongue, loss of appetite, changes in the color of the skin or hair, irritability, and behavioral changes.[1][5] Temporary reversible infertility may occur.[6] Folate deficiency anemia during pregnancy may give rise to the birth of low weight birth premature infants and infants with neural tube defects.[6]

Not consuming enough folate can lead to folate deficiency within a few months.[1] Otherwise, causes may include increased needs as with pregnancy, and in those with shortened red blood cell lifespan.[1] Folate deficiency can be secondary to vitamin B12 deficiency or a defect in homocysteine methyl transferase that leads to a "folate trap" in which is an inactive metabolite that cannot be recovered.[1] Diagnosis is typically confirmed by blood tests, including a complete blood count, and serum folate levels.[1] Increased homocysteine levels may suggest deficiency state, but it is also affected by other factors.[1] Vitamin B12 deficiency must be ruled out, if left untreated, may cause irreversible neurological damage.[1]

Treatment may include dietary changes and folic acid supplements.[1] Dietary changes including eating foods high in folate such as, fruits and green leafy vegetables can help.[1] Prevention is recommended for pregnant women or those who are planning a pregnancy.[1]

Folate deficiency is very rare in countries with folic acid fortification programs.[2] Worldwide prevalence of anemia due to folic acid deficiency generally is very low.[2]

  1. ^ a b c d e f g h i j k l m n o "Folate Deficiency: Practice Essentials, Background, Pathophysiology". 2023-06-30.
  2. ^ a b c Cite error: The named reference Bailey was invoked but never defined (see the help page).
  3. ^ Huether S, McCance K (2004). "20". Understanding Pathophysiology (3rd ed.). Mosby. p. 543. ISBN 978-0-323-02368-9.
  4. ^ Tamparo C (2011). Diseases of the Human Body (Fifth ed.). Philadelphia, PA. pp. 337. ISBN 978-0-8036-2505-1.{{cite book}}: CS1 maint: location missing publisher (link)
  5. ^ Cite error: The named reference Oldref_20 was invoked but never defined (see the help page).
  6. ^ a b "Vitamin B12 or folate deficiency anaemia - Complications". nhs.uk. 2017-10-20. Retrieved 2023-10-31.