ANEMIA, FOLIC-ACID DEFICIENCY

General Information

DEFINITION--Anemia caused by a deficiency of folic acid. It is often accompanied by iron-deficiency anemia.

BODY PARTS INVOLVED--Blood cells, which transport oxygen to all body parts.

SEX OR AGE MOST AFFECTED--Both sexes, but most common in women over 30.

SIGNS & SYMPTOMS

• Fatigue and weakness.
• Red, sore tongue.
• Paleness.
• Shortness of breath.
• Nausea, vomiting and diarrhea (rare).

CAUSES

• Complication of pregnancy, when the body needs 8 times more folic acid than usual.
• Inadequate intake or absorption of foods with a high folic-acid content, such as meat, poultry, fish, cheese, milk, eggs, green vegetables, yeast and mushrooms.
• Alcoholism.
• Overcooking foods, which destroys folic acid.
• Deficiency of vitamin B-12 or vitamin C.

RISK INCREASES WITH

• Adults over 60, especially those who have poor diets.
• Pregnancy.
• Illness, such as tropical sprue, psoriasis, acne rosacea, eczema or dermatitis herpetiformis.
• Fad diets or general poor nutrition, especially vitamin-C deficiency.
• Surgical removal of the stomach.
• Smoking, which decreases vitamin-C absorption. Vitamin C is necessary for folic-acid absorption.
• Use of certain drugs, such as oral contraceptives, anticonvulsants, methotrexate, triamterene or sulfasalazine.

HOW TO PREVENT

• Don't drink alcohol.
• Have regular medical checkups during pregnancy. Take prenatal vitamin supplements, if they are prescribed.
• Eat well. Include fresh vegetables, meat and other animal proteins. Avoid fad diets. Don't overcook food.
• Don't smoke. Smoking increases vitamin requirements.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies and possibly a Schilling test to measure vitamin B-12 levels and a therapeutic trial of vitamin B-12.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.

POSSIBLE COMPLICATIONS

• Infertility.
• Increased susceptibility to infection.
• Congestive heart failure (severe cases only).

PROBABLE OUTCOME--Usually curable in 3 weeks with an adequate folic-acid intake.

How To Treat

GENERAL MEASURES--

• If you smoke, stop smoking.
• If you take oral contraceptives, consider using another form of contraception.

MEDICATION--Your doctor may prescribe:

• Folic-acid supplements.
• Iron supplements to take orally.

ACTIVITY--Anemia causes fatigue. Schedule regular rest periods until you are able to resume normal activity.

DIET--No special diet. Eat foods daily that are high in folic acid. The liver can store folic acid for a limited time only. Foods include asparagus spears, beef liver, broccoli spears, collards (cooked), mushrooms, oatmeal, peanut butter, red beans, wheat germ.

Call Your Doctor If

• You have symptoms of anemia.
• Symptoms don't improve in 2 weeks, despite treatment.
• Symptoms of infection (fever, chills and muscle aches) occur during treatment.