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Overview
  • Also known as vitamin B
    or folate
  • Used to form tetrahydrofolate (THF)
    • important for DNA and RNA synthesis
  • Found in leafy greens and fresh fruits
  • Absorbed in the jejunum and ileum
  • Small reserve pool is stored in the liver
    • lasts 3-4 months
Deficiency
  • Folic acid deficiency causes a megaloblastic anemia
  • Most common vitamin deficiency in the United States 
  • Causes
    • dietary deficiency
      • elderly
      • goat milk
    • alcoholism
    • pregnancy 
    • deficiency can be caused by several drugs
      • e.g., phenytoin, sulfonamides, methotrexate, EtOH, 5-fU, and oral contraceptives
  • Presentation
    • macrocytic, megaloblastic anemia 
    • homocystinemia
      • ↑ risk of DVT and atherosclerosis
      • supplemental folic acid can reverse this risk
    • no neurologic symptoms (as opposed to vitamin B12 deficiency)
    • deficiency in pregancy causes fetal neural tube defects
      • supplemental folic acid in early pregnancy reduces risk
 

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