Folic Acid Deficiency: What is it, Causes, Symptoms and Treatment

By Editor On Jan 5, 2024

Folic Acid Deficiency: What is it, Causes, Symptoms and Treatment

Folic acid deficiency is when the level of folic acid in the body is lower than normal due to different reasons.

Folic acid deficiency is when the level of folic acid in the body is lower than normal due to different reasons. Folic acid deficiency has negative effects on general health. It is possible to prevent folic acid deficiency by consuming foods rich in folate or using nutritional supplements.

What is Folic Acid Deficiency?

Folic acid, also known as folate, is a type of B vitamin. Folic acid, also called vitamin B9, has many functions in the body. Folic acid; It is necessary for DNA replication that occurs during division in cells. Folic acid is also needed to repair any damage that may occur in DNA during replication. One of the most important functions of folic acid is its involvement in red blood cell production. Red blood cells (red blood cells) are responsible for carrying oxygen to cells in the body. Since the average lifespan of red blood cells is 120 days, these cells must be constantly destroyed and rebuilt. Folic acid (vitamin B9) and cobalamin (vitamin B12) are also needed for the production of new red blood cells.

Folic acid deficiency is a condition that occurs when the amount of folic acid the body needs is not taken. In healthy people, the folic acid value in the blood should be between 2.7-17.0 ng/mL. People whose folic acid value is below the ideal range are diagnosed with folic acid deficiency. Folic acid deficiency causes serious problems in people. Folic acid deficiency, especially seen in pregnant women, can lead to serious problems in the baby if it is not prevented and treated.

Folic acid value being above the ideal range usually does not cause a problem. However, high folic acid values may indicate vitamin B12 deficiency. The body needs vitamin B12 to use folic acid. If a person has a vitamin B12 deficiency, an increase in folic acid levels may occur because folic acid cannot be used sufficiently. When such a condition is suspected, vitamin B12 levels should also be checked in addition to folic acid in the blood.

What are the symptoms of Folic Acid Deficiency?

It may be difficult to notice these symptoms when the symptoms seen in the patient with folic acid deficiency are not very severe. Again, the symptoms seen in folic acid deficiency may be similar to the symptoms seen in different disorders. Therefore, various tests are needed to distinguish whether these symptoms develop due to folic acid deficiency.

Symptoms of folic acid deficiency:

Tiredness

hair graying
mouth sores
swelling of the tongue
It can be listed as growth and development problems.

What Causes Folic Acid Deficiency?

Folic acid is a type of water-soluble vitamin. For this reason, folic acid cannot be stored in the fat tissue in the body. Since folic acid has no reserves in the body, it must be taken regularly. Problems in taking or absorbing folic acid cause folic acid deficiency. Conditions that are effective in the development of deficiency:

Diet: Deficiency may occur in people who do not consume enough fresh vegetables and fruits and who do not consume enough foods enriched with folic acid (such as milk, yoghurt, flour, breakfast cereal). Folic acid deficiency may begin to appear within a few weeks after malnutrition begins.
Diseases: Diseases that disrupt nutrient absorption from the intestine can cause folic acid deficiency. Examples of these disorders are; Crohn’s disease, celiac disease, and some types of cancer can be given.
Genetics: In some people, the body does not convert folic acid into its active form, methylfolate. This condition is caused by mutation in the gene that codes for the enzyme that provides the relevant transformation.
Drug Side Effects: Drugs such as phenytoin, trimethoprim-sulfamethoxazole, methotrexate, sulfasalazine; It may cause folic acid deficiency as a side effect.

How to Diagnose Folic Acid Deficiency?

Folic acid testing is performed in patients with suspected folic acid deficiency or in people with a disease that may cause deficiency (e.g. celiac disease).

To diagnose folic acid deficiency, a blood test is required from the patient. The blood sample taken from the patient is examined for folic acid in the laboratory and the folic acid level in the blood is determined. According to the result here, a patient’s folic acid level below 2.7 ng/mL indicates deficiency.

Since folic acid and vitamin B12 deficiency can occur together, B12 analysis may be requested in the patient’s blood test.

What are the symptoms that occur with folic acid deficiency?

Folic acid deficiency has a negative impact on general health.

The most common problem caused by folic acid deficiency is megaloblastic anemia. In this type of anemia, the patient has a problem in making red blood cells. Low red blood cells in the patient:

Feeling tired all the time, getting tired easily
Weakness
Numbness

Shortness of breath
Pale skin color, pallor
It causes symptoms such as restlessness.

In folate deficiency, a decrease in the number of white blood cells and platelets (platelets) as well as red blood cells may be observed. Decrease in white blood cells in the person; It causes problems such as susceptibility to infection and delayed wound healing. In case of low platelets, problems occur in blood clotting. As a result of this situation, the patient; Problems such as redness and bruising may occur even as a result of minor trauma, and blood clotting may occur even after a small cut.

Folic acid deficiency during pregnancy can lead to the development of very serious problems in the baby. Low folic acid levels of the mother during pregnancy may cause a condition called neural tube defects in the baby. The neural tube is the structure that will form the brain and spinal cord of the baby in the womb in the future. Folic acid deficiency causes problems in the closure of the neural tube during the embryological period and the baby is born with a neural tube defect. The most common forms of neural tube defects are; These are conditions called spina bifida and anencephaly. In spina bifida, the spinal cord is not located within the spine as it normally should be. There is a problem in the placement of the spinal cord. Anencephaly is a condition in which parts of the baby’s brain and skull are missing.

Symptoms that may be seen in babies born with neural tube defects may vary depending on the disorder seen in the baby. However, in general, in patients with neural tube defects; Very serious problems such as vision and hearing problems, mental retardation, and loss of consciousness are encountered.

To prevent neural tube defects, it would be beneficial for women to take folic acid supplements as soon as they start planning to become pregnant.

Folic Acid Deficiency Treatment

Treatment of folic acid deficiency is done by increasing the patient’s daily folate intake or taking folic acid supplements.

In order to reach the required daily folic acid levels, it is beneficial to consume foods containing high amounts of folate. Foods rich in folic acid:

Green leafy vegetables such as broccoli and spinach
brussels sprouts
Pea

Citrus
Melon
ice
Tomatoes
Egg

legumes
Mushroom
Liver, white meat, red meat
shellfish

can be listed as.

If the patient’s deficiency is severe, high-dose folic acid supplements can be used in the treatment for a rapid recovery. If the patient has a different micronutrient deficiency accompanying folic acid deficiency, multivitamin supplements may also be preferred in the treatment.

If you suspect that you or someone close to you may have folic acid deficiency, or if you are planning to become pregnant, it would be beneficial to contact a healthcare provider and have the necessary check-ups.