Anemia- folate deficiency

Anemia-folate deficiency is a decrease in the red cells in the blood caused by folate (folic acid) deficiency.

Causes, incidence, and risk factors

Folate or folic acid is necessary for red blood cell formation and growth. Dietary sources of folate are found in green leafy vegetables and liver. Some medications such as Dilantin interfere with the absorption of this vitamin. Because folate is not stored in the body in large amounts, a continual dietary supply of this vitamin is needed. In folate deficiency anemia , the red cells are abnormally large and are referred to as megalocytes, and in the bone marrow as megaloblasts. Subsequently, this anemia may be referred to as megaloblastic anemia Causes of the anemia are poor dietary intake of folic acid as in chronic alcoholism , malabsorption diseases such as celiac disease and sprue , and certain medications. A relative deficiency due to increased need for folic acid may occur in the third trimester of pregnancy . Risk factors are a poor diet (seen frequently in the poor, the elderly, and in people who do not buy fresh fruits or vegetables), overcooking food, alcoholism, having a history of malabsorption diseases, and pregnancy. The incidence is 4 out of 100,000 people.

Signs and tests

  • Low red blood cell
  • folate level.
  • A
  • complete blood count shows anemia and large red blood cells.
  • A
  • bone marrow examination is rarely necessary, but shows megaloblasts.


    The objective of treatment is to treat the underlying cause of the anemia , which may be dietary or a malabsorption disease. Oral or intravenous folic acid supplements may be taken on a short term basis until the anemia has been corrected, or in the case of poor absorption by the intestine, replacement therapy may be lifelong. Dietary treatment consists of increasing the intake of green leafy vegetables and citrus fruits.

    Expectations (prognosis)

    Anemia usually responds well to treatment with correction of the abnormalities within 2 months.


    Symptoms of anemia can cause discomfort. In a pregnant woman, folate deficiency has been associated with neural tube or spinal defects (such as spina bifida ) in the infant.

    Calling your health care provider

    Call for an appointment with your health care provider if symptoms indicate anemia of folate deficiency may be present.


    Adequate dietary intake in high-risk individuals and folic acid supplementation during pregnancy may help prevent the onset of this anemia.

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