Symptoms of folate deficiency and what it could mean – Medical News Bulletin

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Folate deficiency is a common nutritional deficiency that can be caused by a lack of dietary folate intake, increased turnover of cells, malabsorption, or excessive alcohol intake.

Folate (vitamin B-9) is a vital nutrient that is required for amino acid synthesis, conversion of homocysteine to methionine, and DNA replication.

Dietary folate can be found in foods including leafy green vegetables, legumes (black beans and kidney beans), egg yolk, and citrus fruit. The daily requirement is usually 50 micrograms (mcg) but increases to 400 mcg in pregnancy for the growth and development of the fetus.

A blood test can be used to check levels of folate, vitamin B-12 (cobalamin), and hemoglobin (a protein involved in oxygen transport). By using a folate test to identify low levels of folate in the blood, you could avoid potential negative outcomes of deficiency.

Common symptoms of folate deficiency include fatigue, headaches, irritability, mouth sores, and swelling of the tongue.

Folate supplementation can help prevent complications, which is why it is now recommended to those at risk of deficiency and women planning for pregnancy.

Megaloblastic anemia

Megaloblastic anemia is the most common manifestation of folate or vitamin B-12 deficiency. Megaloblastic anemia causes inhibition of DNA synthesis, leading to ineffective red blood cell production. Clinical features of megaloblastic anemia include larger and more immature blood cells, weakness, loss of appetite, and jaundice. Folate deficiency anemia can be diagnosed using a health test to measure serum or red blood cell folate and treated with daily folic acid supplements.

Neurological disorders

Folate deficiency is associated with neurological disorders including depression, mania, and cognitive decline. Low folate concentrations are common in patients with depression and is also associated with greater severity of depression. Other neurological diseases, such as Parkinson’s disease and epilepsy, have been linked to reductions in both red blood cell folate and folate consumption through the diet.

Vitamin supplements may improve symptoms in depressive patients by acting in combination with traditional antidepressant medications. Home health tests are useful in the diagnosis of folate deficiency to help accelerate the treatment of neurological disorders.

Birth defects

Maternal diet is the source of all the essential elements needed for the development of the fetus. Birth defects are a common symptom of folate deficiency, which have been combatted in many countries through food folate fortification. Folate supplements are advised to women before and during pregnancy to prevent congenital abnormalities, including neural tube defects, cardiovascular malformations, cleft lip and palate, and limb reductions.

Neural tube formation occurs in the first month of pregnancy and leads to the development of the brain and spinal cord. Neural tube defects, such as spina bifida, results in incomplete closing of the spine and can lead to permanent disability.

A folate test can be used to diagnose deficiencies and provide additional support for pregnant women and their offspring. Adequate consumption of folates has been found to have a 50-70% protective effect on preventing neural tube defects.

Occlusive vascular disease

Homocysteine is a naturally occurring amino acid that is involved in the production of methionine. Since this process is dependent on B-vitamins, low red cell folates are associated with an accumulation of homocysteine in the blood and a higher risk of developing occlusive vascular artery disease. Occlusive vascular artery disease causes reduced blood flow due to a narrowing of the arteries or veins and commonly leads to coronary heart disease and heart attacks.

Administration of folic acid or vitamin B-12 can lower plasma levels of homocysteine, particularly in dialysis patients. For this reason, home tests to check B-vitamin levels may be useful for those at risk of folate or vitamin B-12 deficiency.

Colonic polyposis

Malabsorption of folate frequently occurs in diseases of the intestines. Low folate status is a risk factor for colonic polyposis, which are small growths on the lining of the large intestine.

Celiac disease is an immune-mediated disorder triggered by the consumption of gluten, which leads to inflammation of the small bowel mucosa. Micronutrient deficiencies, including iron, folate, vitamin B-12, and vitamin D, are frequently found in celiac patients at the time of diagnosis. Colon polyps can lead to severe complications, such as osteoporosis and cancer.

Detecting low folate levels

It is important to promptly recognise folate deficiency and track improvements through supplementation; this can be achieved using home health tests. A folate testing kit checks folate levels in the blood to avoid the development of symptoms of folate deficiency and verify whether treatment is required. You should always consult your doctor before taking any supplements to make sure they are right for you.

Written by Albina Babu, MSc

References:

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2. Greenberg, J.A., et al. (2011). Folic acid supplementation and pregnancy: more than just neural tube defect prevention. Reviews in Obstetrics and Gynecology, 4(2), p.52.

3. Khallafallah, A.A. and Mohamed, M. (2012). Nutritional anaemia. Anemia. IntechOpen.

4. Socha, D.S., et al. (2020). Severe megaloblastic anemia: vitamin deficiency and other causes. Cleveland Clinic Journal of Medicine, 87(3), pp.153-164.

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9. Safi, J., Joyeux, L. and Chalouhi, G.E. (2012). Periconceptional folate deficiency and implications in neural tube defects. Journal of Pregnancy, pp.1-9.

10. Stabler, S.P., 2015. Anemias due to essential nutrient deficiencies. Nutrition for the Primary Care Provider. Karger Publishers, 111, pp.164-168.

11. Wolffenbuttel, B.H., et al. (2019). The many faces of cobalamin (vitamin B12) deficiency. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 3(2), pp.200-214.

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14. McGlynn, A.P., et al. (2013). Low colonocyte folate is associated with uracil misincorporation and global DNA hypomethylation in human colorectum. The Journal of Nutrition, 143(1), pp.27-33.

15. Rondanelli, M., et al. (2019). Micronutrients dietary supplementation advices for celiac patients on long-term gluten-free diet with good compliance: a review. Medicina, 55(7), p.337.

Image by Aline Ponce from Pixabay 





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