Description
Folic acid, also known as folate or vitamin B9, is a water-soluble vitamin found in food. It is one of 8 vitamins of the group B.
Folate is required for the synthesis and repair of nucleic acids – DNA and RNA. Folic acid plays key role in the production of red blood cells (RBCs) and therefore the most spread result of vitamin B9 deficiency is folic acid deficiency anemia (the condition when the count of RBCs is reduced).
The current recommended daily intake of folic acid is 400 micrograms per day.
The following foods are rich in folic acid:
Asparagus;
Avocado;
Baker’s yeast;
Beetroot;
Broccoli;
Brussel sprouts;
Cabbage;
Cauliflower;
Egg yolk;
Jacket potato (large);
Kidney;
Lentils;
Lettuce;
Liver (pregnant women should not consume liver);
Many fruits (especially oranges, papaya and kiwi);
Milk;
Mushrooms;
Parsnips;
Peas;
Pork;
Poultry;
Seafood;
Spinach;
Sunflower seeds;
Whole wheat bread (usually fortified);
Causes and risk factors
Folate deficiency may be caused by the reduced intake of folic acid rich foods and poor nutrition. Overcooking may also destroy the vitamin in the food.
Some diseases interfere with the absorption of the folate in the gastrointestinal tract, including Crohn’s disease, celiac disease, alcohol abuse, cancer and kidney problems that require dialysis. Alcohol also causes increased excretion and destruction of folic acid in the body.
Some genetic mutations decrease the ability of the body to convert the dietary folate into the usable form, methylfolate.
Intake of phenytoin (Dilantin), trimethoprim-sulfamethoxazole, methotrexate and sulfasalazine may also cause folic acid deficiency.
Folate requirements are higher in case of:
Infancy;
pregnancy (due to a rapid fetal growth);
lactation;
malignancy;
concurrent infection (immunoproliferative response);
chronic hemolytic anemia (increased hematopoiesis).
[See also: Vitamin D deficiency]
Symptoms
Folic acid deficiency anemia is characterized by the:
Weakness and fatigue;
Appetite and weight loss;
Forgetfulness;
Sore throat and tongue;
Difficulties swallowing;
Shortness of breath;
Headache;
Inability to concentrate;
Pallor;
Irritability;
Sores around the mouth;
Nausea and vomiting;
Abdominal pain;
Diarrhea;
Modest temperature elevation without any signs of infection;
A folate deficiency during pregnancy can lead to birth defects such as spina bifida.
Apart from anemia and birth defects, folate acid deficiency may cause:
A higher risk of second heart attacks and strokes;
A higher risk of some cancer types, such as stomach cancer;
Male infertility;
Clinical depression;
Memory and mental agility problems.
Diagnosis
To verify the diagnosis blood test is performed. Megakaryocyes are found in the blood samples. Serum folate (reference range 2.5-20 ng/mL) may also be measured.
Treatment
Folate deficiency is treated with a folic acid rich diet and the intake of folic acid supplements taken orally.