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Folic Acid Deficiency Anaemia

folic acid

Blood is made up of a fluid called plasma which contains:

  1. Red blood cells - which take oxygen around the body.
  2. White blood cells - which are part of the immune system, and defend the body from infection.
  3. Platelets - which help the blood to clot if we cut ourselves.
  4. Proteins - and other chemicals that have various functions.

Red blood cells are made in the bone marrow, and millions are released into the bloodstream each day. A constant new supply of red blood cells is needed to replace old cells that break down. To make red blood cells and haemoglobin constantly you need a healthy bone marrow and nutrients such as iron and certain vitamins, including folic acid, which we get from food.

What is anaemia and folic acid deficiency anaemia?

Anaemia means that:You have fewer red blood cells than normal,

OR

You have less haemoglobin than normal in each red blood cell

Folic acid is a vitamin and is needed to make new cells in the body, including red blood cells. The body does not store very much folic acid. You need a regular fresh supply to keep healthy. Many foods contain folic acid, including spinach, sprouts, broccoli, green beans, peas, chickpeas, brown rice, kidney, liver and potatoes.

What are the symptoms of folic acid deficiency?

Symptoms due to anaemia are caused by the reduced amount of oxygen in the body. Common symptoms include: tiredness, lethargy, feeling faint, becoming easily breathless.
Less common symptoms include: headaches, palpitations, altered taste and ringing in the ears (tinnitus). You may look pale.

What are the causes of folic acid deficiency?

Not eating enough foods containing folic acid is the most common cause. Groups who often don't eat properly are people who are alcohol-dependent and/or elderly. Pregnancy causes reserves of folic acid in your body to be used by the growing baby. You are at risk of becoming low in folic acid during the later stages of pregnancy, particularly if you do not eat well during pregnancy. Some uncommon conditions of the gut may cause poor absorption of folic acid. For example, coeliac disease.

Some inflammatory conditions can lead to low folic acid levels - for example, severe Crohn's disease. This is less common though.

Some medicines interfere with folic acid. Therefore, you may need to take extra folic acid whilst taking certain medicines. For example, colestyramine, sulfasalazine, methotrexate and some anticonvulsant medicines used to treat epilepsy.

What is the treatment for folic acid deficiency?

Treatment is easy and is by taking a tablet of folic acid each day. You need to take this until the anaemia is corrected and the folic acid stores in the body are built up (usually for about four months). You may need advice on diet to stay well and the tablets can be stopped if your diet improves.

Folic acid and pregnancy

Extra folic acid is advised for at least the first 12 weeks of pregnancy for all women - even if you are healthy and have a good diet. If you take extra folic acid in early pregnancy you have less chance of having a baby born with a spinal cord problem such as spina bifida. It is best to start taking the extra folic acid before becoming pregnant. If the pregnancy is unplanned then start taking folic acid as soon as you know you are pregnant. For most women the dose is 400 micrograms (0.4 mg) a day.


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