BHS, Pittsfield - Folate deficiency. Folate deficiency means you have a...

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First trimester of pregnancy

Folic acid

Early weeks of pregnancy

Definition:

Folate deficiency means you have a lower-than-normal amount of folic acid, a type of B vitamin, in your blood.

See also: Folic acid

Alternative Names:

Deficiency - folic acid, Folic acid deficiency

Causes, incidence, and risk factors:

Folate deficiency is due to a lack of folic acid. Folic acid is found naturally in dark-green leafy vegetables, citrus fruits, beans, and whole grains.

Symptoms:

Folic acid deficiency may cause:

Diarrhea
Gray hair
Mouth ulcers
Peptic ulcer
Poor growth
Swollen tongue

It may also result in a form of megaloblastic anemia .

In addition, folic acid is required for the development of a healthy fetus. It plays an important part in the development of the fetus' spinal cord and brain. Folic acid deficiency can cause severe birth defects of the brain and spinal cord, known as neural tube defects.

In some cases, there may be no noticeable signs of folic acid deficiency, and it is diagnosed in pregnant women only after a child is born with a neural tube defect.

Signs and tests:

Folate deficiency can be diagnosed with a blood test. Pregnant women usually have such blood work during prenatal checkups.

Treatment:

Support Groups:

Expectations (prognosis):

Complications:

Calling your health care provider:

Prevention:

The Institute of Medicine's Food and Nutrition Board recommends that adults should have 400 micrograms of folate daily. Women capable of becoming pregnant should receive this amount with folic acid supplements, not just fortified foods, to ensure the proper daily intake.

Women should begin eating foods and supplements containing folic acid 2-3 months prior to conception and during the first trimester of pregnancy. If women were to take the recommended amount of folic acid before they conceived and through the first trimester of pregnancy, 50-70% of these cases could be prevented. Yet recent research by March of Dimes shows that many women are unaware of the importance of folic acid.

Mothers who are at high risk for having a baby with spinal defect usually will be told to take 10 times the recommended dose of folic acid. This higher dose (4 mg) is only recommended for women who have had family members with spina bifida or who are on drugs that increase their risk, such as some epilepsy medicines. High doses like these have not been shown to help mothers at average risk.

References:

Antony AC. Megaloblastic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 170.

Review Date: 11/10/2008
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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