Folate deficiency causes: Difference between revisions

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__NOTOC__
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{{Folate deficiency}}
{{Folate deficiency}}
 
{{CMG}} {{AE}} {{KS}} {{LRO}}
{{CMG}}


==Overview==
==Overview==
Common causes of folate deficiency include [[gastrointestinal]] conditions, including [[malabsorption syndrome]] and other diseases obstructing [[folate]] absorption. [[Oncological]] causes, including [[leukemia]], [[stomach cancer]], and [[liver cancer]] are life threatening and should be promptly differentiated and diagnosed.<ref name="pmid28189172">{{cite journal| author=Green R, Datta Mitra A| title=Megaloblastic Anemias: Nutritional and Other Causes. | journal=Med Clin North Am | year= 2017 | volume= 101 | issue= 2 | pages= 297-317 | pmid=28189172 | doi=10.1016/j.mcna.2016.09.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28189172  }}</ref>


==Causes==
==Causes<ref name="Oldref_6">{{cite journal | author=Oakley GP Jr, Adams MJ, Dickinson CM | title=More folic acid for everyone, now | journal=Journal of Nutrition | volume=126 | issue=3 | year=1996 | pages=751S-755S | id=PMID 8598560}}</ref><!--
 
A deficiency of folate can occur when your need for folate is increased, when dietary intake of folate is inadequate, and when your body excretes (or loses) more folate than usual. Medications that interfere with your body's ability to use folate may also increase the need for this vitamin.<!--
  --><ref name="Oldref_6">{{cite journal | author=Oakley GP Jr, Adams MJ, Dickinson CM | title=More folic acid for everyone, now | journal=Journal of Nutrition | volume=126 | issue=3 | year=1996 | pages=751S-755S | id=PMID 8598560}}</ref><!--
   --><ref name="Oldref_15">{{cite journal | author=McNulty H| title=Folate requirements for health in different population groups| journal=British Journal of Biomedical Science| volume=52| issue=2 | year=1995| pages=110-9 | id=PMID 8520248}}</ref><!--
   --><ref name="Oldref_15">{{cite journal | author=McNulty H| title=Folate requirements for health in different population groups| journal=British Journal of Biomedical Science| volume=52| issue=2 | year=1995| pages=110-9 | id=PMID 8520248}}</ref><!--
   --><ref name="Oldref_16">{{cite journal | author=Stolzenberg R| title=Possible folate deficiency with postsurgical infection| journal=Nutrition in Clinical Practice | volume=9| issue=6| year=1994| pages=247-50 | id=PMID 7476802}}</ref><!--
   --><ref name="Oldref_16">{{cite journal | author=Stolzenberg R| title=Possible folate deficiency with postsurgical infection| journal=Nutrition in Clinical Practice | volume=9| issue=6| year=1994| pages=247-50 | id=PMID 7476802}}</ref><!--
   --><ref name="Oldref_18">{{cite journal | author=Pietrzik KF and Thorand B | title=Folate economy in pregnancy | journal=Nutrition | volume=13 | issue=11-12 | year=1997 | pages=975-7 | id=PMID 9433714}}</ref><!--
   --><ref name="Oldref_18">{{cite journal | author=Pietrzik KF and Thorand B | title=Folate economy in pregnancy | journal=Nutrition | volume=13 | issue=11-12 | year=1997 | pages=975-7 | id=PMID 9433714}}</ref><!--
   --><ref name="Oldref_19">{{cite journal | author=Kelly GS | title=Folates: Supplemental forms and therapeutic applications | journal=Altern Med Rev | volume=3 | issue=3 | year=1998 | pages=208-20 | id=PMID 9630738}}</ref><!--
   --><ref name="Oldref_19">{{cite journal | author=Kelly GS | title=Folates: Supplemental forms and therapeutic applications | journal=Altern Med Rev | volume=3 | issue=3 | year=1998 | pages=208-20 | id=PMID 9630738}}</ref><!--
   --><ref name="Oldref_17">{{cite journal | author=Cravo ML, Gloria LM, Selhub J, Nadeau MR, Camilo ME, Resende MP, Cardoso JN, Leitao CN, Mira FC | title=Hyperhomocysteinemia in chronic alcoholism: correlation with folate, vitamin B-12, and vitamin B-6 status | journal=The American journal of clinical nutrition | volume=63 | issue=2 | year=1996 | pages=220-4 | id=PMID 8561063}}</ref> Some research indicates that exposure to [[ultraviolet light]], including the use of tanning beds, can lead to a folic acid deficiency. [http://www.americanpregnancy.org/pregnancyhealth/tanningmethods.html] The evolution of human [[skin color]] is partly controlled by the need to have dark skin in the tropics to protect folic acid from ultraviolet light.
   --><ref name="Oldref_17">{{cite journal | author=Cravo ML, Gloria LM, Selhub J, Nadeau MR, Camilo ME, Resende MP, Cardoso JN, Leitao CN, Mira FC | title=Hyperhomocysteinemia in chronic alcoholism: correlation with folate, vitamin B-12, and vitamin B-6 status | journal=The American journal of clinical nutrition | volume=63 | issue=2 | year=1996 | pages=220-4 | id=PMID 8561063}}</ref>==


===Situational===
A deficiency of folate can occur when your need for folate is increased, when dietary intake of folate is inadequate, and when your body excretes (or loses) more folate than usual. Medications that interfere with your body's ability to use folate may also increase the need for this vitamin. Some research indicates that exposure to [[ultraviolet light]], including the use of tanning beds, can lead to a folic acid deficiency.<ref name="BorradaleKimlin2012">{{cite journal|last1=Borradale|first1=David C|last2=Kimlin|first2=Michael G|title=Folate degradation due to ultraviolet radiation: possible implications for human health and nutrition|journal=Nutrition Reviews|volume=70|issue=7|year=2012|pages=414–422|issn=00296643|doi=10.1111/j.1753-4887.2012.00485.x}}</ref> 
Some situations that increase the need for folate include:
* [[Pregnancy]] and [[Breastfeeding|lactation]] (breastfeeding)
* [[Alcoholism]]
* [[Tobacco smoking]]
* [[Malabsorption]], including celiac disease
* [[Kidney dialysis]]
* [[Liver]] disease
* Certain [[anemia]]s.


===Medicational===
===Life Threatening Causes===
Medications can interfere with folate utilization, including:
<div style="-webkit-user-select: none;">
*[[Leukemia]]
*[[Solid tumors]]


* [[Anticonvulsant]] medications (such as [[phenytoin]], and [[primidone]])
===Common Causes===
* [[Metformin]] (sometimes prescribed to control [[glucose|blood sugar]] in [[type 2 diabetes]])
*[[Bacterial overgrowth of small intestine]]
* [[Sulfasalazine]] (used to control inflammation associated with [[Crohn's disease]], [[ulcerative colitis]] and [[rheumatoid arthritis]])
*[[Blind loop syndrome]]
* [[Triamterene]] (a [[diuretic]])
*[[Celiac disease]]
* [[Methotrexate]], an anti-cancer drug also used to control inflammation associated with Crohn's disease, ulcerative colitis and rheumatoid arthritis.
*[[Congenital impairment of folic acid metabolism]]
*[[Crohn's disease]]
*[[Infiltrative bowel disease]]
*[[Inflammatory bowel disease]]
*[[Liver disease]]
*[[Malabsorption syndrome]]
*[[Malnutrition]]
*[[Postoperative]]
*[[Pregnancy]]
*[[Short bowel syndrome]]
*[[Ulcerateive colitis|Ulcerative colitis]]
*[[Vegetarianism]]


=== Inadequate Folate Intake ===
===Causes by Organ System===
{| style="width:80%; height:100px" border="1"
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
| style="width:75%" bgcolor="Beige" ; border="1" | No underlying causes
|-
| bgcolor="LightSteelBlue" | '''Chemical/Poisoning'''
| bgcolor="Beige" | [[Alcoholism]],  [[Cycloserine]],  [[Daraprim]],  [[Ethanol]],  [[Ethotoin]],  [[Maloprim]],  [[Metformin]],  [[Methotrexate]]
|-
|- bgcolor="LightSteelBlue"
| '''Dental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| bgcolor="Beige" | [[Exfoliative dermatitis]],  [[Psoriasis]]
|-
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| bgcolor="Beige" | [[Phenytoin]],  [[Primidone]],  [[Pyrimethamine]],  [[Seromycin pulvules]],  [[Sulfamethoxazole]],  [[Sulfasalazine ]] ,  [[Sulphasalazine]],  [[Triamterene ]] ,  [[Trimethoprim]]
|-
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| bgcolor="Beige" | [[Enzyme defects]],  [[Hyperthyroidism]]
|-
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| bgcolor="Beige" | [[Bacterial overgrowth of small intestine]],  [[Blind loop syndrome]],  [[Celiac disease]],  [[Congenital impairment of folic acid metabolism]],  [[Crohn's disease]],  [[Infiltrative bowel disease]],  [[Inflammatory bowel disease]],  [[Liver disease]],  [[Malabsorption syndrome]],  [[Malnutrition]],  [[Postoperative]],  [[Short bowel syndrome]],  [[Ulcerateive colitis]],  [[Vegetarianism]]
|-
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| bgcolor="Beige" | [[Anemia]],  [[Chronic blood loss]],  [[Chronic hemolytic anemia]],  [[Leukemia]],  [[Macrocytic anemia]]
|-
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| bgcolor="Beige" | [[Postoperative]]
|-
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| bgcolor="Beige" | [[Congenital impairment of folic acid metabolism]],  [[Malnutrition]],  [[Overcooked foods]],  [[Poor dietary intake]],  [[Vegetarianism]]
|-
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| bgcolor="Beige" | [[Lactation]],  [[Pregnancy ]]
|-
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| bgcolor="Beige" | [[Leukemia]],  [[Paraneoplastic syndrome]],  [[Solid tumors]]
|-
|- bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
| bgcolor="Beige" | [[Alcoholism]],  [[Substance abuse]],  [[Tobacco smoking]]
|-
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| bgcolor="Beige" | [[Kidney dialysis]]
|-
|- bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| bgcolor="Beige" | [[Celiac disease]],  [[Crohn's disease]],  [[Cystic fibrosis ]] ,  [[Psoriasis]]
|-
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| bgcolor="Beige" | [[Advanced age]]
|-
|}


* Advanced age
===Causes in Alphabetical Order===
* Alcohol abuse
{{columns-list|
* [[Celiac Disease]]
*[[Advanced age]]
* [[Crohn's Disease]]
*[[Alcoholism]]
* [[Malabsorption]]
*[[Anemia]]
* Malnutrition
*[[Bacterial overgrowth of small intestine]]
* Postoperative
*[[Blind loop syndrome]]
* [[Ulcerateive colitis]]
*[[Celiac disease]]
* Vegetarians
*[[Chronic blood loss]]
*[[Chronic hemolytic anemia]]
*[[Congenital impairment of folic acid metabolism]]
*[[Crohn's disease]]
*[[Cycloserine]]
*[[Cystic fibrosis]]
*[[Daraprim]]
*[[Depression]]
*[[Enzyme defects]]
*[[Ethanol]]
*[[Ethotoin]]
*[[Exfoliative dermatitis]]
*[[Hyperthyroidism]]
*[[Infiltrative bowel disease]]
*[[Inflammatory bowel disease]]
*[[Kidney dialysis]]
*[[Lactation]]
*[[Leukemia]]
*[[Liver disease]]
*[[Macrocytic anemia]]
*[[Malabsorption]]
*[[Malabsorption syndrome]]
*[[Malnutrition]]
*[[Maloprim]]
*[[Metformin]]
*[[Methotrexate]]
*[[Overcooked foods]]
*[[Paraneoplastic syndrome]]
*[[Phenytoin]]
*[[Poor dietary intake]]
*[[Postoperative]]
*[[Pregnancy ]]
*[[Primidone]]
*[[Psoriasis]]
*[[Pyrimethamine]]
*[[Seromycin pulvules]]
*[[Short bowel syndrome]]
*[[Solid tumors]]
*[[Substance abuse]]
*[[Sulfamethoxazole]]
*[[Sulfasalazine ]]
*[[Tobacco smoking]]
*[[Triamterene ]]
*[[Trimethoprim]]
*[[Ulcerateive colitis]]
*[[Vegetarianism]]
}}
</div>


=== Increased Folate Utilization ===
==References==
{{reflist|2}}


* Childhood
{{WS}}
* Chronic blood loss
{{WH}}
* Chronic hemolytic anemia
* [[Hyperthyroidism]]
* Lactation
* [[Leukemia|Leukemias]]
* Macrocytic anemia
* Other anemias
* Pregnancy
* [[Psoriasis]]
* Solid tumors


=== Other ===
[[Category:Gastroenterology]]
* Congenital impairment of folic acid metabolism
[[Category:Hematology]]
* Drugs
* Enzyme defects
* Hematologic diseases
 
==References==
{{Reflist|2}}

Latest revision as of 20:59, 10 January 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2] Luke Rusowicz-Orazem, B.S.

Overview

Common causes of folate deficiency include gastrointestinal conditions, including malabsorption syndrome and other diseases obstructing folate absorption. Oncological causes, including leukemia, stomach cancer, and liver cancer are life threatening and should be promptly differentiated and diagnosed.[1]

Causes[2][3][4][5][6][7]

A deficiency of folate can occur when your need for folate is increased, when dietary intake of folate is inadequate, and when your body excretes (or loses) more folate than usual. Medications that interfere with your body's ability to use folate may also increase the need for this vitamin. Some research indicates that exposure to ultraviolet light, including the use of tanning beds, can lead to a folic acid deficiency.[8]

Life Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning Alcoholism, Cycloserine, Daraprim, Ethanol, Ethotoin, Maloprim, Metformin, Methotrexate
Dental No underlying causes
Dermatologic Exfoliative dermatitis, Psoriasis
Drug Side Effect Phenytoin, Primidone, Pyrimethamine, Seromycin pulvules, Sulfamethoxazole, Sulfasalazine  , Sulphasalazine, Triamterene  , Trimethoprim
Ear Nose Throat No underlying causes
Endocrine Enzyme defects, Hyperthyroidism
Environmental No underlying causes
Gastroenterologic Bacterial overgrowth of small intestine, Blind loop syndrome, Celiac disease, Congenital impairment of folic acid metabolism, Crohn's disease, Infiltrative bowel disease, Inflammatory bowel disease, Liver disease, Malabsorption syndrome, Malnutrition, Postoperative, Short bowel syndrome, Ulcerateive colitis, Vegetarianism
Genetic No underlying causes
Hematologic Anemia, Chronic blood loss, Chronic hemolytic anemia, Leukemia, Macrocytic anemia
Iatrogenic Postoperative
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic Congenital impairment of folic acid metabolism, Malnutrition, Overcooked foods, Poor dietary intake, Vegetarianism
Obstetric/Gynecologic Lactation, Pregnancy 
Oncologic Leukemia, Paraneoplastic syndrome, Solid tumors
Ophthalmologic No underlying causes
Overdose/Toxicity Alcoholism, Substance abuse, Tobacco smoking
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte Kidney dialysis
Rheumatology/Immunology/Allergy Celiac disease, Crohn's disease, Cystic fibrosis , Psoriasis
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous Advanced age

Causes in Alphabetical Order

References

  1. ↑ Green R, Datta Mitra A (2017). "Megaloblastic Anemias: Nutritional and Other Causes". Med Clin North Am. 101 (2): 297–317. doi:10.1016/j.mcna.2016.09.013. PMID 28189172.
  2. ↑ Oakley GP Jr, Adams MJ, Dickinson CM (1996). "More folic acid for everyone, now". Journal of Nutrition. 126 (3): 751S–755S. PMID 8598560.
  3. ↑ McNulty H (1995). "Folate requirements for health in different population groups". British Journal of Biomedical Science. 52 (2): 110–9. PMID 8520248.
  4. ↑ Stolzenberg R (1994). "Possible folate deficiency with postsurgical infection". Nutrition in Clinical Practice. 9 (6): 247–50. PMID 7476802.
  5. ↑ Pietrzik KF and Thorand B (1997). "Folate economy in pregnancy". Nutrition. 13 (11–12): 975–7. PMID 9433714.
  6. ↑ Kelly GS (1998). "Folates: Supplemental forms and therapeutic applications". Altern Med Rev. 3 (3): 208–20. PMID 9630738.
  7. ↑ Cravo ML, Gloria LM, Selhub J, Nadeau MR, Camilo ME, Resende MP, Cardoso JN, Leitao CN, Mira FC (1996). "Hyperhomocysteinemia in chronic alcoholism: correlation with folate, vitamin B-12, and vitamin B-6 status". The American journal of clinical nutrition. 63 (2): 220–4. PMID 8561063.
  8. ↑ Borradale, David C; Kimlin, Michael G (2012). "Folate degradation due to ultraviolet radiation: possible implications for human health and nutrition". Nutrition Reviews. 70 (7): 414–422. doi:10.1111/j.1753-4887.2012.00485.x. ISSN 0029-6643.

Template:WS Template:WH

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