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A.D.A.M. Medical Encyclopedia.

Folate-deficiency anemia

Last reviewed: February 8, 2012.

Folate-deficiency anemia is a decrease in red blood cells (anemia) due to a lack of folate. Folate is a type of B vitamin. It is also called folic acid.

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues.

Causes, incidence, and risk factors

Folate (folic acid) is needed for red blood cells to form and grow. You can get folate by eating green leafy vegetables and liver. However, your body does not store folate in large amounts. So, you need to eat plenty of folate-rich foods to maintain normal levels of this vitamin. 

In folate-deficiency anemia, the red  blood cells are abnormally large. Such cells are called megalocytes. They are also called megaloblasts. They are seen in the bone marrow. This is why this anemia is also called megaloblastic anemia.

Causes of this type of anemia include:

The following raise your risk for this type of anemia:

  • Alcoholism
  • Eating overcooked food
  • Poor diet (often seen in the poor, the elderly, and people who do not eat fresh fruits or vegetables)
  • Pregnancy

Folic acid is needed to help a baby in the womb grow properly. Too little folic acid during pregnancy may lead to birth defects in a baby. For more information see: Folic acid and birth defect prevention

Symptoms

Signs and tests

The doctor or nurse will perform a physical exam. Tests that may be done include:

Rarely, a bone marrow examination may be done.

Treatment

The goal is to identify and treat the cause of the folate deficiency.

You may receive folic acid supplements, taken by mouth or given through a vein. If you have low folate levels because of a problem with your intestines, you make need treatment for the rest of your life.

Diet changes can help boost your folate level. Eat more green, leafy vegetables and citrus fruits.

Expectations (prognosis)

Anemia usually responds well to treatment within 2 months.

Complications

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

Other, more severe complications may include:

Calling your health care provider

Call for an appointment with your health care provider if you have symptoms of folate deficiency anemia.

Prevention

Eating plenty of folate rich foods can help prevent this condition.

Experts recommend that women take 400 micrograms (mcg) of folic acid every day before you get pregnant through the first 3 months of pregnancy.

References

  1. Antony AC. Megaloblastic anemias. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 167.

Review Date: 2/8/2012.

Reviewed by: Todd Gersten, MD, Hematology/Oncology, Palm Beach Cancer Institute, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Also reviewed by Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Folic acid supplementation in pregnancy
    Folate is a naturally occurring vitamin while folic aid is the synthetic replacement of folate used in most supplements and in fortified foods. Folate is essential as its deficiency can be caused by poor dietary intake, genetic factors or the interaction between genetic factors and the environment. Women with sickle cell disease and those women in areas where malaria is endemic have a greater need for folate and in these areas anaemia can be a major health problem during pregnancy. Women need more folate in pregnancy to meet their need for extra blood and to meet the growing baby's need for blood. Without adequate folate intake in a mother's diet, she can become anaemic and this can contribute to her baby being small, anaemic and born too early (preterm birth). Folic acid supplementation taken before conception can reduce the chance of the baby having neural tube defects. This review looked to see if taking folic acid supplements during pregnancy could reduce the chance of the baby being born too early and of low birthweight and to see its impact on the mother’s blood (hematological values), folate levels and on pregnancy complications.
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