Folate-deficiency anemia
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
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...
Read Article Now Book Mark ArticleAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues.
Causes
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 macrocytes. They are also called megaloblasts, when they are seen in the bone marrow. That is why this anemia is also called a type of megaloblastic anemia.
Folate-deficiency
Folate deficiency means you have a lower-than-normal amount of folic acid, a type of vitamin B, in your blood.
Read Article Now Book Mark ArticleCauses of this type of anemia include:
- Too little folic acid in your diet
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Hemolytic anemia
Hemolytic anemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Normally, red ...
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Alcoholism
Alcohol use disorder is when your drinking causes serious problems in your life, yet you keep drinking. You may also need more and more alcohol to f...
Read Article Now Book Mark Article - Use of certain medicines (such as phenytoin [Dilantin], methotrexate, sulfasalazine, triamterene, pyrimethamine, trimethoprim-sulfamethoxazole, and barbiturates)
The following raise your risk for this type of anemia:
- Alcoholism
- Eating overcooked food
- Poor diet (often seen in the poor, the older people, and people who do not eat fresh fruits or vegetables)
- Pregnancy
- Weight loss diets
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.
Folic acid during pregnancy
Taking folic acid before and during pregnancy can reduce the risk for certain birth defects. These include spina bifida, anencephaly, and some heart...
Read Article Now Book Mark ArticleSymptoms
Symptoms may include:
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Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark Article - Weakness
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Headache
Headache
A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...
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Pallor
Pallor
Paleness is an abnormal loss of color from normal skin or mucous membranes.
Read Article Now Book Mark Article - Sore mouth and tongue
Exams and Tests
Your health care provider will perform a physical exam. Tests that may be done include:
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Complete blood count (CBC)
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
Read Article Now Book Mark Article - Red blood cell folate level
In rare cases, a bone marrow aspiration may be done.
Bone marrow aspiration
Bone marrow is the soft tissue inside bones that helps form blood cells. It is found in the hollow part of most bones. Bone marrow aspiration is th...
Read Article Now Book Mark ArticleTreatment
The goal is to identify and treat the cause of the folate deficiency.
You may receive folic acid supplements by mouth, injected into muscle, or through a vein (in rare cases). If you have low folate levels because of a problem with your intestines, you may need treatment for the rest of your life.
Diet changes can help boost your folate level. Eat more green, leafy vegetables and citrus fruits.
Outlook (Prognosis)
Folate-deficiency anemia most often responds well to treatment within 3 to 6 months. It will likely get better when the underlying cause of the deficiency is treated.
Possible 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.
Spina bifida
Myelomeningocele is a birth defect in which the backbone and spinal canal do not close fully before birth. The condition is a type of neural tube de...
Read Article Now Book Mark ArticleOther more severe complications may include:
- Curly graying hair
- Increased skin color (pigment)
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Infertility
Infertility
Infertility means you cannot get pregnant (conceive). There are 2 types of infertility:Primary infertility refers to couples who have not become preg...
Read Article Now Book Mark Article - Worsening of heart disease or heart failure
Heart failure
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
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When to Contact a Medical Professional
Contact your 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 to 800 micrograms (mcg) of folic acid every day before they get pregnant and through the first 3 months of their pregnancy.
References
Antony AC. Megaloblastic anemias. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 40.
Kumar V, Abbas AK, Aster JC. Hematopoietic and lymphoid systems. In: Kumar V, Abbas AK, Aster JC, Deyrup AT, Das A, eds. Robbins and Kumar Basic Pathology. 11th ed. Philadelphia, PA: Elsevier; 2023:chap 10.
Stabler SP. Megaloblastic anemias. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 150.
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Anemia
Animation
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Megaloblastic anemia - view of red blood cells - illustration
This picture shows large, dense, oversized, red blood cells (RBCs) that are seen in megaloblastic anemia. Megaloblastic anemia can occur when there is a deficiency of vitamin B-12.
Megaloblastic anemia - view of red blood cells
illustration
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Blood cells - illustration
Blood is comprised of red blood cells, platelets, and various white blood cells.
Blood cells
illustration
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Megaloblastic anemia - view of red blood cells - illustration
This picture shows large, dense, oversized, red blood cells (RBCs) that are seen in megaloblastic anemia. Megaloblastic anemia can occur when there is a deficiency of vitamin B-12.
Megaloblastic anemia - view of red blood cells
illustration
-
Blood cells - illustration
Blood is comprised of red blood cells, platelets, and various white blood cells.
Blood cells
illustration
Review Date: 3/31/2024
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.