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Updated: Aug 11 2019

Folic Acid

  • Overview
    • Also known as vitamin B9 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
      • hypersegmented neutrophils
      • 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 all reproductive-age women who are attempting to become pregnant reduces risk 
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