Folic Acid Deficiency Anemia - Causes, Symptoms, How To Treat?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Folate deficiency anemia

Folic acid deficiency anemia develops when the body is deficient in folic acid, also called vitamin B9. Symptoms of this disorder are characterized by increased weakness, pallor and slight yellowness of the skin, increased heart rate and low blood pressure. In addition, the patient may experience disorders of the digestive system, severe weight loss and a change in the size of the spleen.

It is not difficult to detect anemia, most often a blood test is sufficient, although sometimes a bone marrow puncture is required. The therapy is based on taking folic acid in dosages prescribed by the doctor.

Content:

• Folic acid deficiency anemia - what is it?
• Causes of occurrence
• Folic acid deficiency anemia symptoms
• Diagnostics of the folate deficiency anemia
• How to treat?
• Prevention of folate deficiency anemia

Folic acid deficiency anemia - what is it?

Folic acid deficiency anemia refers to megaloblastic anemia. The reason for its development lies in the deficiency of folic acid, which a person either does not receive from food, or the body is not able to assimilate it, or it consumes too quickly.

This type of anemia is less commonly diagnosed than B12-deficiency anemia. Although a combination of these two anemias cannot be ruled out, and sometimes iron deficiency anemia is also added to them.

Folic acid deficiency anemia is a dangerous condition for women in a situation, as it negatively affects the development of the fetus. The likelihood of such complications of pregnancy as: abruption of the placenta, early birth, the birth of a premature baby also increases. Therefore, not only therapists and hematologists, but also gynecologists and obstetricians are engaged in the diagnosis of this condition.

Causes of occurrence

The body cannot synthesize folic acid on its own. He gets it from food, where it is present in the form of folates. Valuable sources of vitamin B9 are foods such as: legumes, spinach, lettuce, broccoli, animal liver, meat, yeast, chocolate, etc.

The body's depot contains from 5 to 10 mg of folic acid. Every day he spends about 50 mcg, and during gestation, the consumption of vitamin B9 is 150 mcg per day. Therefore, if a person stops receiving folate from food, then its deficiency in the body will develop in about 3-5 months. The first symptoms of anemia can be seen when the level of folic acid drops to 4 ng / ml of blood.

The following factors can lead to the development of folate deficiency anemia:

• Low intake of the substance with food.
• Impaired absorption of folic acid in the intestine.
• Excessive excretion of folic acid from the body.

In the overwhelming majority of cases, anemia is formed precisely as a result of errors in nutrition. An unbalanced menu, deliberately restricting oneself in food, will necessarily lead to a deficiency of a trace element. Folic acid is destroyed during heat treatment, so long-term cooking at high temperatures is negative.

Women who are carrying a baby or breastfeeding a baby need higher doses of folic acid. Also, the needs of this vitamin increase in children born before the due date, in people with cancer. The risk group for the development of folate deficiency anemia includes patients with psoriasis, hemolytic anemia, hemoblastosis, exfoliative dermatitis.

As for the impaired absorption of folic acid in the intestine, a similar problem is relevant for people suffering from alcoholism, for patients who have undergone resection of the stomach or intestines.

The process of absorption of vitamin B9 can be hampered by such disorders and pathologies as:

• Crohn's disease.
• White diarrhea (sprue).
• B12-deficiency anemia.
• Taking some medicines: drugs to eliminate seizures, barbiturates, hormonal contraceptives, etc.

The third factor in the development of folate deficiency anemia is hidden in the excessive excretion of folic acid from the body, which is observed in cirrhosis of the liver, during hemodialysis, and also against the background of heart failure.

Vitamin B9 is absorbed in the duodenum and in the jejunum. From them, it enters the bloodstream, where it finds plasma proteins and attaches to them. In the form of such a compound, folic acid is sent to the liver. A certain part of it remains in stocks, while the other part is excreted by the kidneys.

In the human body, vitamin B9 is in the form of tetrahydrofolic acid.

He needs it for the synthesis of many important substances, such as:

• Glutamic acid
• Pyrimidine compounds
• Purine compounds.
• Thymidine monophosphate, which is included in the structure of DNA.

If the body lacks folic acid, then the blood cells are not able to divide normally. The process of normoblastic hematopoiesis is replaced by megaloblastic hematopoiesis. Failure in hematopoiesis against the background of anemia leads to the development of leukopenia and thrombocytopenia.

Folic acid deficiency anemia symptoms

The symptoms of folate deficiency anemia are as follows:

• Pale skin that can give off yellowness.
• Increased heart rate.
• Decrease in blood pressure.
• Periodic dizziness.
• Disturbances in the work of the digestive system are poorly expressed. Stool thinning may occur from time to time.
• The spleen slightly increases in size.
• The development of atrophic gastritis cannot be ruled out.
• Symptoms of tongue inflammation are possible.
• With a severe course of the disease, anorexia develops.
• Myocardial dystrophy develops with anemia, as a secondary damage to the heart.

If the patient suffers from schizophrenia, psychosis or epilepsy, then folate deficiency anemia will contribute to the aggravation of the underlying pathology.

Vitamin B9 deficiency is no less dangerous for women who are carrying a fetus. First of all, the child himself is under attack, who may develop a neural tube defect. This will further lead to anencephaly, meningocele, or hydrocephalus. Also, babies who receive less folic acid during intrauterine growth may be born with heart defects, with a "cleft palate" or "cleft lip".

Among the dangers that threaten women with folate deficiency anemia are premature birth, bleeding, miscarriages.

After delivery, young mothers are prone to depression, and their children lag behind in physical and mental development from their peers. In addition, in babies, the immune system functions worse, the intestinal performance suffers.

Diagnostics of the folate deficiency anemia

The tests to be done for a patient with suspected folate deficiency anemia:

• General blood analysis. The lack of folic acid is indicated by: hyperchromia, macrocytosis, leukopenia, thrombocytopenia, low reticulocyte count.
• Determination of the level of folic acid in the serum and erythrocytes. In serum, the normal level of folic acid should remain at around 6-20 ng / ml, and in erythrocytes in the range of 100-450 ng / l.
• Puncture of the bone marrow will detect hyperplasia of the red sprout, and hematopoiesis will proceed according to the megaloblastic type.
• Test with histidine. Folic acid deficiency anemia will be indicated by increased excretion of formiminglutamic acid with urine.
• ECG. In the results of the electroencephalogram, a violation of the repolarization of the left ventricular myocardium will be detected.
• An ultrasound of the internal organs will detect an increase in the size of the spleen.

When carrying out differential diagnostics, folate deficiency anemia should be distinguished from other types of anemia, with acute erythromyelosis and myelodysplastic syndrome.

How to treat?

After the diagnosis is established, the patient is prescribed treatment. It is imperative to direct efforts to eliminate the factors that led to the development of anemia.

First, you need to adjust the patient's diet. Its menu includes foods that are rich in vitamin B9. In parallel, the patient must take folic acid orally. The dose of the drug is 1-5 mg per day. Therapy should be continued for 1-1.5 months. Intramuscular administration of folic acid is possible if its deficiency is caused by malabsorption at the intestinal level. Such patients should be registered with a hematologist and receive a vitamin throughout their lives.

Prevention of folate deficiency anemia

People who are at risk of developing folate deficiency anemia require prophylactic administration of the drug. This applies to pregnant women, patients with thalassemia and hemolytic anemia.

All pregnant women, without exception, need to take folic acid immediately after they find out about their situation. Ideally, expectant mothers should drink folic acid during pregnancy planning. For this purpose, the drug is prescribed at a dosage of 0.4 mg per day. Folic acid intake is indicated during breastfeeding. If you follow these recommendations, then the likelihood of having a child with disturbances in the functioning of the central nervous system is reduced by 3.5 times.

The author of the article: Shutov Maxim Evgenievich | Hematologist

Education: In 2013 he graduated from the Kursk State Medical University and received a diploma "General Medicine". After 2 years, completed residency in the specialty "Oncology". In 2016 completed postgraduate studies at the National Medical and Surgical Center named after N. I. Pirogov.