Folate deficiency classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

There is no established system for the classification of Folate deficiency. However, it can be classified into different categories,based on the causative factors.

Classification

There is no established system for the classification of Folate deficiency. However, it can be classified as follows :

Folate deficiency related to increased requirement:

Some situations that increase the need for folate, may lead to folate deficiency in the body. These include:

• Hemorrhage
• Kidney dialysis
• Liver disease
• Pregnancy and lactation
• Alcohol consumption
• Malignancy

Medication induced Folate Deficiency:

Medications can interfere with folate utilization, including:

• Anticonvulsant medications e.g phenytoin
• Metformin 
• Methotrexate, an anti-cancer drug also used as an anti-inflammatory
• Sulfasalazine, used in Inflammatory bowel syndrome
• Birth control pills

Genetic or Metabolic disorder:

• Defects in folate metabolism
• Defects in folate absorption

Dietary Deficiency:

• A diet low in fresh fruits, vegetables, and fortified cereals

Folate deficiency related to increased destruction:

• superoxides can inactivate folate

Folate deficiency due to increased loss:

• Vitamin B12 deficiency causes "folate trap" and inhibits the utilization of folate in the body
• Chronic alcoholism leads to increased excretion of folate into bile
• Excessive urinary excretion as in chronic dialysis

Endocrine causes of folate deficiency:

• Hypothyroidism which leads to decreased hepatic levels of the enzyme dihydrofolate reductase

Folate deficiency due to malabsorption:

• celiac disease
• tropical sprue
• achlorhydria
• bacterial overgrowth in blind loops
• strictures
• adhesions
• diverticula