FOLIC ACID

Folic acids are required for essential biochemical reactions that provide precursors for the synthesis of amino acids, purines and DNA.Daily requirement is 50 -100mg. Folic acid deficiency is not uncommon.

Sources include yeast, liver, kidney and green vegetables.

Phamacokinetics

Unaltered folic acid is readily and completely absorbed in the proximal jejunum. 5 -20 mg of folates are stored in the liver and other tissues. Body stores of folates are relatively low and daily requirement is high and hence folic acid deficiency and magaloblasitc anemia can develop within 1 -6 months after the in take of folic acid stops. Folates are excreted in the urine and stool.

Deficiency:

Common among elderly patients, poor patients, pregnant ladies. It results in megaloblasiic anemia. Congenital malformation in newborn like spina bifida are also consequences of folate deficiency during pregnancy.

Causes

Dietary deficiency, alcoholics with liver disease, hemolytic anemia, malabsorption syndrome, patients with cancer, leukemia, myeloprolferative disorders, chronic skin diseases, patients on renal dialysis and patients on drugs that impair absorption or metabolism e.g. phenrytoin, oral contraceptive, isoniazid, methotrexate etc.

Treatment

Folic acid 1mg orally per day.

N.B

• Folic acid supplementation to prevent folic acid deficiency should be considered in high-risk individuals including pregnant women, alcoholics and patients with hemolytic anemia, liver disease, certain skin disease, and patients on renal dialysis.

• The administration of folic acid in the setting of vitB₁₂ deficiency will not prevent neurological manifestation even though it will largely correct the anemia caused by the vitamin B ₁₂ deficiency.