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   --><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>==
   --><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>==


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.<!--
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.  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_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_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_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.  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.  


===Situational===
===Life Threatening Causes===
Some situations that increase the need for folate include:
<div style="-webkit-user-select: none;">
* [[Pregnancy]] and [[Breastfeeding|lactation]] (breastfeeding)
* [[Alcoholism]]
* [[Tobacco smoking]]
* [[Malabsorption]], including celiac disease
* [[Kidney dialysis]]
* [[Liver]] disease
* Certain [[anemia]]s.


===Medicational===
===Common Causes===
Medications can interfere with folate utilization, including:


* [[Anticonvulsant]] medications (such as [[phenytoin]], and [[primidone]])
===Causes by Organ System===
* [[Metformin]] (sometimes prescribed to control [[glucose|blood sugar]] in [[type 2 diabetes]])
{|style="width:80%; height:100px" border="1"
* [[Sulfasalazine]] (used to control inflammation associated with [[Crohn's disease]], [[ulcerative colitis]] and [[rheumatoid arthritis]])
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
* [[Triamterene]] (a [[diuretic]])
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
* [[Methotrexate]], an anti-cancer drug also used to control inflammation associated with Crohn's disease, ulcerative colitis and rheumatoid arthritis.
|-
* [[Sulfamethoxazole/Trimethoprim (oral)]]
|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]]
|-
|}


=== Inadequate Folate Intake ===
===Causes in Alphabetical Order===
 
{{columns-list|3|
* Advanced age
*[[Advanced age]]
* Alcohol abuse
*[[Alcoholism]]
* [[Celiac Disease]]
*[[Anemia]]
* [[Crohn's Disease]]
*[[Bacterial overgrowth of small intestine]]
* [[Malabsorption]]
*[[Blind loop syndrome]]
* Malnutrition
*[[Celiac disease]]
* Postoperative
*[[Chronic blood loss]]
* [[Ulcerateive colitis]]
*[[Chronic hemolytic anemia]]
* Vegetarians
*[[Congenital impairment of folic acid metabolism]]
 
*[[Crohn's disease]]
=== Increased Folate Utilization ===
*[[Cycloserine]]
 
*[[Cystic fibrosis ]]
* Childhood
*[[Daraprim]]
* Chronic blood loss
*[[Depression]]
* Chronic hemolytic anemia
*[[Enzyme defects]]
* [[Hyperthyroidism]]
*[[Ethanol]]
* Lactation  
*[[Ethotoin]]
* [[Leukemia|Leukemias]]
*[[Exfoliative dermatitis]]
* Macrocytic anemia
*[[Hyperthyroidism]]
* Other anemias
*[[Infiltrative bowel disease]]
* Pregnancy
*[[Inflammatory bowel disease]]
* [[Psoriasis]]
*[[Kidney dialysis]]
* Solid tumors
*[[Lactation]]
 
*[[Leukemia]]
=== Other ===
*[[Liver disease]]
* Congenital impairment of folic acid metabolism
*[[Macrocytic anemia]]
* Drugs
*[[Malabsorption]]
* Enzyme defects
*[[Malabsorption syndrome]]
* Hematologic diseases
*[[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>


==References==
==References==

Revision as of 16:42, 3 March 2017

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

Overview

Causes[1][2][3][4][5][6]

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. 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.

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

The unnamed parameter 2= is no longer supported. Please see the documentation for {{columns-list}}.
3

References

  1. ↑ Oakley GP Jr, Adams MJ, Dickinson CM (1996). "More folic acid for everyone, now". Journal of Nutrition. 126 (3): 751S–755S. PMID 8598560.
  2. ↑ McNulty H (1995). "Folate requirements for health in different population groups". British Journal of Biomedical Science. 52 (2): 110–9. PMID 8520248.
  3. ↑ Stolzenberg R (1994). "Possible folate deficiency with postsurgical infection". Nutrition in Clinical Practice. 9 (6): 247–50. PMID 7476802.
  4. ↑ Pietrzik KF and Thorand B (1997). "Folate economy in pregnancy". Nutrition. 13 (11–12): 975–7. PMID 9433714.
  5. ↑ Kelly GS (1998). "Folates: Supplemental forms and therapeutic applications". Altern Med Rev. 3 (3): 208–20. PMID 9630738.
  6. ↑ 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.

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