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Folic deficiency anemia: causes, symptoms, treatment and prevention


Folic deficiency anemia is a hematological disease that begins to develop with insufficient intake of folic acid.Against the backdrop of this deficiency, a number of disorders occur in the body, but the most significant of them will affect the hematopoiesis system.If the pathological process under consideration is protracted, then in the bone marrow, the formation of erythrocytes slows down considerably, which leads to megaloblastic anemia.

Table of contents:

Reasons for the development of folate deficiency anemia

There are several factors that lead to the disease in question.

Folate deficiency in the diet

This reason is most common in medical practice, since the main source of folic acid for humans is food and if the diet is lean, then this trace element simply does not enter the body in sufficient quantity .Often, folic deficiency anemia occurs in those people who already have a history of chronic pathological processes and at the same time feeds inadequately.

For products that are rich in folic acid, include:

  • beef liver;
  • raw vegetables( for example, carrots, spinach, lettuce leaves);
  • eggs;
  • some cheeses;
  • beans;
  • honey;
  • bread with bran, but only coarse;
  • avocado and citrus fruits;
  • yeast dough.


If these products are not consumed, the chances of acquiring folia deficiency anemia increase dramatically.But it is worth noting that other foods not listed in the list contain the micronutrient in question, however, in a much smaller number - doctors insist that the diet should be varied and full.

Note: in young children, folic acid deficiency anemia can develop when switching from breast milk to goat - it lacks folic acid, and taking into account the age of the child and its adaptation to the world, the disease under consideration will develop rapidly.

Diseases of the gastrointestinal tract

Any pathology of the digestive system can trigger the development of folic acid deficiency anemia, and this is due to the fact that folic acid, even with absolute health, is not completely absorbed by the body, and even with minor disturbances in the work of the gastrointestinal tractThe insufficiency of this microelement will be felt.

To diseases of the gastrointestinal tract that lead to the development of folic deficiency anemia, include:

  • Anemia peptic ulcer of the stomach and / or duodenum;
  • Crohn's disease;
  • Hepatitis and / or cirrhosis of the liver proceeding in chronic form;
  • celiac disease - gluten intolerance;
  • gastritis;
  • enteritis and gastroenteritis taking place in a chronic form.

With all these diseases, the mucous membrane of the small intestine is damaged, so the absorption of nutrients in general and folic acid in particular is impaired. People with the above pathologies are at risk - doctors recommend that they take a blood test at least once every six months to promptly diagnose the onset of the disease in question.

Dysbacteriosis of the intestine and parasitic infections

With the intestinal dysbacteriosis, the normal content of beneficial microorganisms in the microflora is disrupted, their place is occupied by pathogenic bacteria.They serve as an obstacle to the normal absorption of nutrients, including, and folic acid.A prolonged course of intestinal dysbiosis leads to the deficiency of this important trace element, but this development does not mean that folic deficiency anemia will take place in severe form, rather, vice versa.

But the severe form of the disease can take in the case of parasitic infections, because many helminths themselves absorb folic acid and the presence in the body of just one such parasite can lead to severe anemia.

Increased body needs for folic acid

Medicine know cases when the disease under consideration develops even against the background of sufficient intake of folic acid.Most often this happens in pregnancy, psoriasis, malignant neoplasms, dermatitis.

Use of certain medications

Even if a person takes medications in strict accordance with the prescription of a doctor, foliceworthy anemia may develop.Of course, not all medicines serve as provoking factors, such only apply:

  • phenobarbital;
  • cycloserine;
  • is diphenine;
  • isoniazid;
  • Methotrexate;
  • triamterene.

Note: the main problem is that the abolition of these drugs is most often impossible - they are used to treat tuberculosis, cancer, convulsive syndrome.Therefore, doctors just in parallel with them prescribe and medications that can provide the body with the right amount of folic acid.

In addition, folic deficiency anemia can develop against a backdrop of chronic alcoholism and the presence of enzyme disorders.

Symptoms of folic acid deficiency anemia

In principle, the symptoms of the disease in question are similar to those of other types of anemia. Separately it is worth highlighting the most intensive ones:

  1. Weakness, tinnitus and dizziness.Their appearance is due to the disruption of supply of the brain with oxygen, which leads to hypoxia of the brain and disruption of the central nervous system.Outwardly, such a mechanism for the development of folic deficiency anemia is manifested by rapid fatigue, the patient's working capacity decreases, he feels constant discomfort from headaches and tinnitus.It is noteworthy that the listed symptoms are not taken seriously by patients and they rarely address doctors, and it is at this stage that it is possible to diagnose folic deficiency anemia at the very beginning of its development.Shortness of breath, tachycardia and palpitation.These symptoms are nothing more than an attempt by the body to compensate for the lack of red blood cells.The cardiovascular and respiratory systems begin to work in a strengthened mode, trying to increase the flow of oxygen.Especially intensively, these signs of the disease in question are manifested in old age.Dyspnea, as a rule, is of a short-term nature, but tachycardia is permanent.
  2. Pale skin.By the way, it is the pale skin tone that is considered to be the most obvious sign of anemia, which the doctor pays attention to during a quick examination of the patient.With folio-deficient anemia, the pallor of the skin will be ubiquitous, that is, the palms, and the feet, and the abdomen will be pale.This symptom manifests itself immediately after a decrease in hemoglobin in the blood and persists for a long time.Patients note that against the background of the pallor of the skin they become too sensitive to cold.Fingerness of nails and hair, dryness of skin.
  3. .These symptoms are related to the fact that the lack of oxygen in the tissues of the body leads to disturbances in metabolic processes.Hair becomes thin, dry, lose its luster and cease to grow.Fingernails break, the skin suffers - it not only becomes excessively dry, but is also often traumatized.Moreover, even small scratches heal very long.

There are several more signs of folic acid deficiency anemia, which manifest themselves in the absence of treatment.For example, the patient may note chronic disruption of the gastrointestinal tract - regardless of food intake, diarrhea or constipation appears, there is a constant feeling of heaviness in the abdomen, often from patients complain of pain in the intestine.

Diagnostic measures

Diagnosis of folic acid deficiency anemia has several objectives:

  • to detect and confirm the development of anemia;
  • determine to what extent the severity of the disease occurs;
  • find out the cause of the development of folic deficiency anemia.

Therefore, if a doctor suspects a given disease, the doctor must prescribe a comprehensive examination to the patient, which includes:

  • Anemia general and biochemical blood tests;
  • general urinalysis;
  • assay for folic acid;
  • parasitologic blood test;
  • bone marrow puncture;
  • special blood tests;
  • radiography;
  • fibro-esophagogastroduodenoscopy.

Treatment of folic deficiency anemia

Modern medicine can quickly and effectively perform therapeutic measures that will restore the normal level of folic acid in the body. As a rule, the disease in question does not require hospitalization of the patient, but there are exceptions - the following categories of patients are necessarily placed in the hospital:

  • anemia is severe - hemoglobin level below 70 g / l;
  • the patient has severe concomitant diseases;
  • the patient is in elderly or senile age;
  • is in parallel determined by the deficiency in the body of vitamin B12 ;
  • there are complications.

The general principles of treatment of a given disease in outpatient and inpatient settings do not differ:

  1. First, the root cause of folic acid deficiency anemia is eliminated.Antiparasitic drugs, medicines for the treatment of pathologies of the gastrointestinal tract may be prescribed.If the cause of the disease in question is chronic alcoholism, then first the patient undergoes treatment in a narcological clinic and only after that it makes sense to replenish the level of folic acid in the body.
  2. Administration of folic acid preparations.If the anemia is mild, the patient is prescribed folic acid at a dose of 1-5 mg daily.The course of treatment lasts 4-6 weeks, but the first positive changes in the patient's condition will be noticeable on the 5th-7th day of treatment.If folic acid deficiency anemia is severe, then this drug is taken immediately in a higher dosage( at least 5 mg per day), in parallel with it, vitamin B12 preparations are prescribed.

Note : Patients with folic deficiency anemia in the hospital are not for long - once the blood tests show a positive trend( this occurs on the 3-5 day of treatment), the patient is discharged home for further treatment on an outpatient basis.

Preventive measures

Treatment of folic acid deficiency anemia is not difficult, but it is much wiser to prevent its development .As part of the prevention of this type of anemia, doctors recommend:

  • folic acid maintain a complete diet;
  • for the prevention of folic acid( especially important in pregnancy), but only after consulting a doctor;
  • use alcoholic beverages very moderately;
  • medications should be taken only at the doses prescribed by your doctor;
  • chronic diseases not only in time to diagnose, but also to treat.

Folic deficiency anemia does not pose a threat to human life, but such disorders in the body can lead to the development of undesirable consequences.When the first signs of this disease appear, it is worthwhile to apply for qualified medical help, undergo treatment and again to lead a full-fledged, active lifestyle.

Tsygankova Yana Aleksandrovna, medical reviewer, therapeutist of the highest qualification category

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