Symptoms
Diarrhea, loss of appetite, and weight loss can occur. Additional signs are weakness, sore tongue, headaches, heart palpitations, irritability, and behavioral disorders.Women with folate deficiency who become pregnant are more likely to give birth to low birth weight and premature infants, and infants with neural tube defects.
In adults, anemia (Macrocytic, Megaloblastic anemia) is a sign of advanced folate deficiency.
In infants and children, folate deficiency can slow growth rate.
Some of these symptoms can also result from a variety of medical conditions other than folate deficiency. It is important to have a physician evaluate these symptoms so that appropriate medical care can be given.
Causes
A deficiency of folate can occur when your need for folate is increased, when dietary intake of folate is inadequate, and when your body excretes (or loses) more folate than usual. Medications that interfere with your body's ability to use folate may also increase the need for this vitamin.Some research indicates that exposure to ultraviolet light, including the use of tanning beds, can lead to a folic acid deficiency. The evolution of human skin color is partly controlled by the need to have dark skin in the tropics to protect folic acid from ultraviolet light.
Some situations that increase the need for folate include:
- pregnancy and lactation (breastfeeding)
- Alcoholism
- Tobacco smoking
- malabsorption, including celiac disease
- kidney dialysis
- liver disease
- certain anemias.
Medication
Medications can interfere with folate utilization, including:- anticonvulsant medications (such as phenytoin, and primidone)
- metformin (sometimes prescribed to control blood sugar in type 2 diabetes)
- sulfasalazine (used to control inflammation associated with Crohn's disease, ulcerative colitis and rheumatoid arthritis)
- triamterene (a diuretic)
- methotrexate, an anti-cancer drug also used to control inflammation associated with Crohn's disease, ulcerative colitis and rheumatoid arthritis.
