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We all might be familiar with iron-deficiency anaemia because each of us would have been anaemic at some point in their lives. But you will be surprised to know there are several other forms of anaemia as well – like thalassemia, sickle cell anaemia, folate deficiency anaemia. We will be covering the latter topic in this article.
Now why is this form of anaemia caused by deficiency of folic acid so important? As the name suggests, the anaemia results from the lack of folate or folic acid in the diet. Folic acid or vit B9 is an important vitamin for women who are trying to get pregnant. It is very essential for the development of the foetus. Most of the O & G doctors prescribe this vitamin for people who are trying to start a family. Read on to find out more about this vitamin.
What Is Folic Acid?
Folic acid, or folate, is a type of B vitamin. It helps to:
- “manufacture” DNA
- Repair or mend DNA
- Produce RBCs (red blood cells)
These are some of the important raw material that the body needs. DNA is the basic of all requirements. So what happens if there is a deficiency of this folic acid in the diet?
Well, to put it in simple terms, you could end up with a folic acid deficiency. Decreased intake folic acid can result in a deficiency within a few weeks’ time. Other than deficient intake, deficiency can also occur due to genetic reasons – a mutation in the DNA that can prevent the body from absorption or conversion of folate to its usable form or absorption of folate. Folic acid deficiency can cause anemia. Anemia is a condition where there are very few RBCs in the body. Less RBCs in turn mean that the cells and tissues in the body are deprived of oxygen – RBCs transport oxygen in the body to cells and tissues to carry out their functions.
Why is Folic Acid important?
Folic acid is of great importance to women especially, of childbearing age. If a deficiency occurs during pregnancy, it can lead to birth defects. Enough amount of folic acid can be obtained from diet/food. However, supplements are advised for women who intend to start a family.
What could be the causes of Folic Acid Deficiency?
- Folic acid is a water-soluble vitamin – cannot be stored in fat cells. This means that you need to keep consuming folate as your body cannot develop a reserve.
- Since it is water-soluble, excess amounts of this vitamin is released in the urine.
Other reasons for Folic Acid Deficiency include:
Genetics
Some people have a mutation in their genes (polymorphism) that deters the body from converting the available folate into its usable form, methylfolate.
Diet
A diet poor in a variety of vegetables, fruits and fortified cereals is the foremost cause of folic acid deficiency. Also, overcooking food can at times destroy essential vitamins. Unless we consume a diet rich in folic acid/folate, the levels of folic acid in the body can go down drastically in just a very short span of time.
Disease
Folic acid deficiency can also occur due to diseases that hinder absorption in the GI or gastrointestinal tract. Some of these diseases include:
- Celiac disease
- Crohn’s disease
- Certain cancers
- In cases of severe kidney problems that require dialysis
Excessive Alcohol Intake
Excess of anything did no one any good. Similarly, alcohol (as is common in most cases) hinders the absorption of folic acid. To add to this, alcohol also increases excretion of folate via urine.
How can you identify if you have Folic Acid Deficiency?
The symptoms of this deficiency are usually subtle. They include:
- fatigue
- mouth sores
- grey hair
- tongue swelling
- growth problems
The resulting anaemia owing to folic acid deficiency has the following symptoms:
- persistent fatigue
- pale skin
- lethargy
- irritability
- tender tongue
But, if the symptoms are subtle, how can I find out if I have Folic Acid Deficiency?
All it takes is a simple blood test. Get yourselves checked at least once a year. Pregnant women are asked to get their folate levels checked during their regular prenatal check-ups.
Are there any complications that can arise out of Folic Acid Deficiency?
As mentioned earlier, folic acid is essential for RBC production. In case of a deficiency, these are the resulting complications that can occur:
- Megaloblastic anaemia (large, under-developed RBCs)
- Decreased WBC and platelet count
- Spina bifida – serious birth defect in brain and spinal cord of developing foetus. Also referred to as neural tube defects.
How can we treat and prevent the occurrence of Folic Acid Deficiency?
Treatment:
Increased dietary intake of folate along with folic acid supplement.
Folic acid is usually combined with other B vitamins in supplements. These are called vitamin B complexes.
Decrease alcohol intake in general and an absolute no-no for pregnant women.
Prevention:
In order to prevent folic acid deficiency, eating a proper nutritious diet is essential.
Foods rich in folic acid include:
- Green leafy vegetables, such as spinach and broccoli
- Peas
- Citrus juices
- Fruits like banana, melon
- Tomato
- Brussel sprouts
- Eggs
- Legumes and beans
- Mushroom
- Liver meat
- Fortified cerals
- Poultry
What is the recommended dosage of Folic Acid?
The daily recommended dosage of folate is 400 micrograms. Pregnant women, women who are trying to start a family should take a folic acid supplement along with a rich folate diet.
People who are taking medication that can cause folic acid deficiency should also take a supplement, but after consulting your physician.
Pregnancy and after and Folic Acid
Folic acid, as mentioned earlier, is essential to prevent neural tube defects such as spina bifida in the growing foetus.
Taking folic acid supplements can help prevent:
- Premature birth / miscarriage
- Low birth weight of baby
- Cleft lip/palate
So pregnant women are advised to take a dosage of 400 micrograms of folic acid as supplement per day during their first trimester.
During the second and third trimesters, the dosage must be increased to 600 microgram. However, it is essential to continue the supplements even after delivery, especially if the mother is breastfeeding the infant. A dosage of 500 microgram is recommended for a nursing mother. Always consult your ob-gyn before taking the supplements.
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by Hridya Anand
A biochemist by education who could never put what she studied to good use, finally found GetDoc as a medium to do what she loved - bring information to people using a forum that is dedicated to all things medical. View all articles by Hridya Anand.
