Etiologies of Folate Deficiency • Decreased dietary intake - uncommon in this era • Increased requirements - Patients who are pregnant have hemolytic anemia, or psoriasis have increased needs for folate that can cause them rapidly to develop folate deficiency if intake is not kept up. • Malabsorption • Drugs - Patients with underlying mild folate deficiency are more susceptible to trimethoprim/sulfa, pyrimethamine and methotrexate toxicity. Oral contraceptive and anticonvulsants lead to increase consumption of folate. • Alcohol - Alcohol affects several aspects of folate metabolism. Alcoholics have a poor intake of folate. In addition, folate metabolism is interfered with leading to a functional folate deficiency. Alcoholics have an inability to mobilize folate stores and can have depleted tissue stores with normal serum levels of folate. Dr. Thomas DeLoughery @Bloodman #Folate #deficiency #FolicAcid #differential #diagnosis #hematology #nutrition
