An ongoing deficiency of this important B vitamin leads to what is known as macrocytic or megaloblastic anemia. Folate is needed to synthesize DNA, the genetic material that’s required by all cells. When your body lacks folate as a result of poor diet, impaired absorption or an unusually high need for the vitamin, the DNA metabolism is harmed, especially in rapidly dividing cells like red blood cells.
The anemia of folate deficiency is characterized by large, immature red blood cells. Without folate, DNA production slows and red blood cells lose their ability to divide. These immature cells are enlarged and oval shaped. As such, they cannot carry oxygen or travel through the tiny blood vessels (capillaries) as efficiently as normal red blood cells.
To help prevent anemia associated with a folate deficiency, aim to meet your recommended daily allowance: see the RDA table on page 6 in chapter 1. If you are pregnant, your folate requirement rises considerably to cover the needs of rapidly multiplying cells.
Folate for Anemia Photo Gallery
For a look at some of the top dietary folate sources, see the Folate in Foods table on page 7 in chapter 1. You will notice that some of the best sources of folate are leafy green vegetables. In fact, the vitamin’s name is derived from the word “foliage.” Foods deliver folate in a bound form; because your intestine prefers folate in its free form, special enzymes located on the surface of your intestine must first break down the bound folate. The free folate is then absorbed into your bloodstream and delivered to your body’s cells.
Sounds fine so far. The problem is that this complicated system of handling folate from the diet is vulnerable to injuries in the intestinal tract. If your intestinal cells are harmed, then folate is lost from the body. Alcohol abuse and chronic use of aspirin and antacids can disrupt the absorption of folate. If you use the occasional aspirin to relieve a headache you need not be concerned, but if you rely heavily on these medications you are at risk of developing a folate deficiency. The medication Azulfidine® (sulfasalazine), used to treat inflammatory bowel disease such as Crohn’s disease or ulcerative colitis, also interferes with folate absorption.
Other medications that can affect folate levels in the body include oral contraceptives, barbiturates, Metformin® (for type 2 diabetes) and certain anticonvulsant drugs. If you take any of these prescription drugs, check with your pharmacist for possible nutrient interactions.
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