Skip to Content

Folate-deficiency anemia

Definition

Folate-deficiency anemia is a decrease in red blood cells (anemia) due to a lack of folate.

Anemia 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, also called folic acid, is necessary for red blood cell formation and growth. You can get folate by eating green leafy vegetables and liver. Because folate is not stored in the body in large amounts, you need to get a continual supply of this vitamin through diet to maintain normal levels.

In folate-deficiency anemia, the red cells are abnormally large. These large cells are called megalocytes, or megaloblasts in the bone marrow. That is why this anemia can also be called megaloblastic anemia.

Causes of this anemia are:

  • Certain medications (such as phenytoin [Dilantin], alcohol, methotrexate, sulfasalazine, triamterene, pyrimethamine, trimethoprim-sulfamethoxazole, and barbiturates)
  • Chronic alcoholism
  • Crohn's disease, celiac disease, infection with the fish tapeworm, or other problems that make it difficult for your body to digest foods
  • Poor dietary intake of folic acid
  • Surgeries that remove certain parts of your stomach or small intestine, such as some weight-loss surgeries

In the third trimester of pregnancy, a woman may have a deficiency due to an increased need for folic acid. Hemolytic anemia can also cause a deficiency due to increased red blood cell destruction and increased need.

Risk factors include:

  • Alcoholism (which interferes with the absorption of folate)
  • Eating overcooked food
  • Poor diet (often seen in the poor, the elderly, and people who do not eat fresh fruits or vegetables)
  • Pregnancy

The disease occurs in about 4 out of 100,000 people.

Symptoms

Exams and Tests

Treatment

The goal is to identify and treat the cause of the folate deficiency.

Folic acid supplements may be given by mouth (oral) or through a vein (intravenous) on a short-term basis until the anemia has been corrected. In the case of poor absorption by the intestine -- replacement therapy may be lifelong.

Dietary treatment consists of increasing the intake of green, leafy vegetables and citrus fruits.

Outlook (Prognosis)

Anemia usually responds well to treatment within 2 months.

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.

Other, more severe complications may include:

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have symptoms of folate deficiency anemia.

Prevention

Good dietary intake of folate in high-risk individuals, and folic acid supplementation during pregnancy may help prevent this anemia.

References

Antony AC. Megoblastic anemias. In: Hoffman R, Benz EJ, Shattil SS, et al., eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 39.

Kaferie J, Strzoda CE. Evaluation of macrocytosis. Am Fam Physician. 2009;79:203-208.

Review Date: 1/31/2010
Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com

Disclaimer: The information contained in this website, and its associated websites, is provided as a benefit to the local community, and the Internet community in general; it does not constitute medical advice. We try to provide quality information, but we make no claims, promises or guarantees about the accuracy, completeness, or adequacy of the information contained in or linked to this website and its associated sites. As medical advice must be tailored to the specific circumstances of each patient and healthcare is constantly changing, nothing provided herein should be used as a substitute for the advice of a competent physician. Furthermore, in providing this service, Adventist HealthCare does not condone or support all of the content covered in this site. As an Adventist health care organization, Adventist HealthCare acts in accordance with the ethical and religious directives for Adventist health care services.

Adventist HealthCare · 301-315-3030 · 1801 Research BLVD, Suite 400, Rockville, MD 20850

Submit an Online Information Request