Folate

(Folic acid)

Folic acid deficiency is widespread. It is caused by inadequate intake, malabsorption or drug intake. Folate deficiency causes megaloblastic anemia, which can not be distinguished from occurring in vitamin B12 deficiency anemia. Suffers an expectant mother with folate deficiency, the risk of the fetus is increased for a neural tube defect. The diagnosis is made by laboratory tests. The measurement of a neutrophil hyper-segmentation achieved reliably and fast. A treatment by means of oral intake of folate usually takes place successfully.

Folate is added in the US and Canada today enriched grain products. The vitamin is also abundant in different plant foods and meat, but is in favor of complementary products or fortified foods is more bioavailable than in natural foods (see table: sources, functions and effects of vitamins).

(See also overview of vitamins.) Folate is added in the US and Canada today enriched grain products. The vitamin is also abundant in different plant foods and meat, but is in favor of complementary products or fortified foods is more bioavailable than in natural foods (see table: sources, functions and effects of vitamins). Folate plays a role in the maturation of red blood cells and the synthesis of purines and pyrimidines. They are necessary for the development of the fetal nervous system. The absorption takes place in the duodenum and upper jejunum. Enterohepatic circulation of folate occurs. Folatsupplemente protect not (even if they lower the homocysteine ??level) against coronary heart disease or stroke; There is no evidence that a Folatergänzung increases or decreases the risk of various cancers. The upper limit for receiving folate is 1000 mcg; higher daily doses (up to 4 mg) are advisable in women who have a baby with a neural tube defect. Folate is non-toxic. Women taking both oral contraceptives and anticonvulsants, may need to take to Folatsupplemente in to get the contraceptive upright. Folic acid deficiency Folic acid deficiency is widespread. It is caused by inadequate intake, malabsorption or drug intake. Folate deficiency causes megaloblastic anemia, which can not be distinguished from occurring in vitamin B12 deficiency anemia. Suffers an expectant mother with folate deficiency, the risk of the fetus is increased for a neural tube defect. The diagnosis is made by laboratory tests. The measurement of a neutrophil hyper-segmentation achieved reliably and fast. A treatment by means of oral intake of folate usually takes place successfully. Etiology The most common causes of folic acid deficiency inadequate intake (usually in patients with malnutrition or alcoholism) increased demand (eg. As a result of pregnancy or breastfeeding) limited absorption (eg. As in celiac disease or certain medications) Deficiency can also by inadequate bioavailability and increased excretion occur (see table: reasons for folate deficiency). Reasons for folate deficiency root cause Inadequate supply shortage of raw, green vegetables or enriched grain products in the diet; chronic alcoholism, TPE Limited absorption celiac sprue, more malabsorption syndromes, antiepileptics, congenital or acquired Folatmalabsorption Inadequate recovery folate antagonists (metformin, methotrexate, triamterene, trimethoprim), anticonvulsants, congenital or acquired enzyme deficiency, alcoholism Increased demand pregnancy, lactation, infancy / infancy , increased metabolism increased excretion dialysis (peritoneal or Hämodi alyse) Long cooking times destroy folate and predispose a person for an inadequate intake. The feed is partially barely adequate (eg. As in alcoholics). Deposits in the liver store a supply of the nutrient for only a few months. Alcohol affects the Folatabsorption, metabolism, renal excretion and the enterohepatic reabsorption and reduces the healthy food intake. 5-fluorouracil, metformin, methotrexate, phenobarbital, phenytoin, sulfasalazine, and trimethoprim inhibit Folatmetabolisierung. In the US and Canada, many foods (such. As grain, grain products) routinely fortified with folate, resulting in the risk of a lack reduziert.Symptome and discomfort A folate deficiency to glossitis, diarrhea, depression and confusion. Anemia may progress slowly and eventually more severe due to the compensation process, as the symptoms appear to testify. During pregnancy, folate deficiency increases the risk of fetal neural tube defects and possibly Hirnschäden.Diagnose blood count, serum vitamin B12und folate The CBC has possibly a megaloblastic anemia which, if not indistinguishable from the anemia of vitamin B12 deficiency. Is the result for serum folate <3 mcg / l or ng / ml (<7 nmol / l), a defect is likely. The Serumfolatgehalt reflects folate status, unless the supply has recently increased or decreased. Has the supply is changed, the folate levels of red blood cells are more accurate information about the tissue depots. A level of <140 mcg / L or ng / ml (<305 nmol / l) indicates an insufficient state. Also, increased homocysteine ??levels suggests a geweblichen folate deficiency, but this mirror is also influenced by vitamin B12und vitamin B6 budget of an existing renal insufficiency and genetic factors. A normal Methylmalonsäurespiegel allows discrimination of folate deficiency of a vitamin B12 deficiency because Mythylmalonsäurewerte increase in vitamin B12 deficiency, but not in Folatmangel.Therapie Supplementary oral folate intake Oral administration of 400-1000 mcg folate daily tissue depots filled and is usually even more successful if the defect was created by malabsorption. The normal requirement is 400 mcg / day. (Cave. In patients with megaloblastic anemia, a vitamin B12 deficiency before treatment must be excluded with folate If a vitamin B12 deficiency, the Folatergänzung can indeed improve the anemia, but not heal and can even neurological deficits worse). For pregnant women, the recommended daily nutrient intake (Recommended daily allowance, RDA) is 600 mcg / day. For women who have already given birth to a child with a neural tube defect, the recommended dose is 4000 mcg / day, the application will start one month before conception (if possible) and will last until 3 months after Empfängnis.Wichtige points most frequently is a folate deficiency to a reduced uptake (z. B. due to alcoholism), an increased demand (eg. as a result of pregnancy) or a disturbed resorption (for. example, due to drugs or malabsorption) due. Prolonged cooking destroys folate, but many staple foods contain folate. A deficiency causes megaloblastic anemia and partially glossitis, diarrhea, depression and confusion. In patients who have a megaloblastic anemia, folate and vitamin B12 is to be measured in serum. For the treatment of the defect, the patients will also receive once daily 400-1000 mcg p.o. Folate.

Health Life Media Team

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