Folic acid deficiency
Pro Research Analysisby 
Searched over 200M research papers
Understanding Folic Acid Deficiency: Causes, Symptoms, and Implications
Introduction to Folic Acid Deficiency
Folic acid, also known as vitamin B9, is essential for numerous bodily functions, including DNA synthesis and repair, cell division, and growth. Deficiency in folic acid can lead to a variety of health issues, ranging from anemia to cognitive impairments. This article explores the causes, symptoms, and broader implications of folic acid deficiency.
Causes of Folic Acid Deficiency
Poor Intake and Absorption
Folic acid deficiency often results from inadequate dietary intake or poor absorption. This can occur due to malnutrition or diseases affecting the small intestine, such as celiac disease, tropical sprue, or jejunitis 137. Additionally, certain medications, including anti-folic compounds and anticonvulsant drugs like primidone and phenobarbitone, can interfere with folic acid absorption 137.
Increased Demand
Increased physiological demand for folic acid, such as during pregnancy, can also lead to deficiency. Pregnant women require higher levels of folic acid to support fetal development, and failure to meet these increased demands can result in deficiency 8. The minimum daily requirement during pregnancy is estimated to be between 300-500 mcg 8.
Symptoms of Folic Acid Deficiency
Hematological Symptoms
One of the primary manifestations of folic acid deficiency is macrocytic anemia, characterized by the presence of large, immature red blood cells (megaloblastic erythropoiesis) 137. Other hematological symptoms include glossitis (inflammation of the tongue), weight loss, and diarrhea 137.
Neurological and Cognitive Symptoms
While folic acid deficiency typically does not cause neurological symptoms, it can lead to cognitive impairments, especially in the elderly. Studies have shown that low folic acid levels are associated with high homocysteine levels, which can increase the risk of dementia and Alzheimer's disease 49. However, supplementation with folic acid, with or without vitamin B12, has not shown significant benefits in improving cognitive function in elderly individuals 4.
Broader Health Implications
Cardiovascular Health
Folic acid deficiency has been linked to elevated homocysteine levels, which are associated with an increased risk of cardiovascular diseases. Elevated homocysteine can lead to oxidative stress and endothelial dysfunction, contributing to atherosclerosis and other cardiovascular conditions 5.
Cancer Risk
Folic acid plays a crucial role in DNA synthesis and repair. Deficiency in folic acid can lead to DNA instability, increasing the risk of cancer, particularly colorectal cancer. Mechanisms include altered DNA methylation and uracil misincorporation, which can activate proto-oncogenes and cause chromosome breakage 6.
Pregnancy Complications
Folic acid deficiency during pregnancy can lead to severe anemia and megaloblastic changes in the bone marrow. It is also associated with an increased risk of neural tube defects in the fetus, premature separation of the placenta, and third-trimester bleeding 8. Routine supplementation of folic acid is recommended for all pregnant women to prevent these complications 8.
Conclusion
Folic acid deficiency is a significant health concern with wide-ranging implications, from anemia and cognitive decline to increased risks of cardiovascular diseases and cancer. Understanding the causes and symptoms of this deficiency is crucial for effective prevention and treatment. Ensuring adequate intake through diet or supplementation, especially in high-risk groups such as pregnant women and the elderly, is essential for maintaining overall health.
Sources and full results
Most relevant research papers on this topic
Folic acid deficiency
Folic acid deficiency can cause macrocytic anemia, glossitis, weight loss, diarrhoea, and neurological symptoms, and may result from poor intake, poor absorption, increased demand due to disordered metabolism, or a combination of these factors.
Folic Acid Deficiency in the Elderly
Low folic acid levels in the elderly can lead to a variety of health issues, including anemia, thrombosis, and a reduced ability to metabolize folate-dependent enzymes.
Literature ReviewFolic Acid Deficiency
Folic acid deficiency can cause macrocytic anamia, glossitis, weight loss, diarrhoea, and neurological symptoms without evidence of vitamin B12 deficiency.
Folic acid with or without vitamin B12 for cognition and dementia.
Folic acid supplementation, with or without vitamin B12, may improve cognitive function in elderly individuals at risk of cognitive decline or dementia.
Systematic Review
Highly CitedPro-thrombotic effects of a folic acid deficient diet in rat platelets and macrophages related to elevated homocysteine and decreased n-3 polyunsaturated fatty acids.
Folic acid deficiency can increase platelet activation and coagulation, potentially due to decreased n-3 polyunsaturated fatty acids and increased homocysteinemia.
Non-RCT
Animal StudyHighly CitedFolic acid deficiency and cancer: mechanisms of DNA instability.
Folic acid deficiency may increase the risk of cancer by altering DNA methylation and causing imbalances in DNA precursors and chromosome breakage.
Highly CitedFolic acid deficiency.
Folic acid deficiency can cause macrocytic anamia, glossitis, weight loss, diarrhcra, and neurological symptoms without evidence of vitamin B12 deficiency.
Folic acid deficiency in pregnancy. On the recognition, pathogenesis, consequences, and therapy of the deficiency state in human reproduction.
Folic acid deficiency in pregnancy is common and can lead to severe anemia and megaloblastic marrow changes, requiring daily supplementation during pregnancy.
Folic Acid Deficiency and Homocysteine Impair DNA Repair in Hippocampal Neurons and Sensitize Them to Amyloid Toxicity in Experimental Models of Alzheimer's Disease
Folic acid deficiency and high homocysteine levels impair DNA repair in neurons, making them more vulnerable to oxidative damage induced by amyloid -peptide, which is linked to Alzheimer's disease.
Non-RCTAnimal StudyHighly CitedFolic acid deficiency and vision: a review
Folic acid (FA), also termed folate, is an essential vitamin for health at all ages since it participates in the biosynthesis of nucleotides, amino acids, neurotransmitters, and certain vitamins. It is therefore crucial for rapidly growing tissues such as those of the fetus. It is becoming clear that FA deficiency and impaired folate pathways are implicated in many diseases of both early life and old age. FA can be transported into the cell by the folate receptor, the reduced folate transporter, and proton-coupled folate transporter. Folate transport proteins are present in certain eye tissues, which explains why FA plays an important role in eye development. The purpose of this literature review is to investigate the evidence relating FA deficiency to eye diseases.
Literature Review
Rigorous Journal