Folate-deficiency anemia

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Blood cells

Megaloblastic anemia - view of red blood cells

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.

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.

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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.

Review Date: 01/31/2010
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.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).