ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences
Folate deficiency
Print
Other Resources UpToDate PubMed

Folate deficiency

Print Images (1)
Contributors: Michael W. Winter MD, Marilyn Augustine MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Folate deficiency refers to a deficiency of vitamin B9. Folate is a water-soluble vitamin that is essential to DNA synthesis. It is naturally present in many foods, particularly leafy vegetables. Additionally, in many countries, foods are fortified with folate, such as pastas and flours. In the United States, folate deficiency is rare in the general population in the absence of underlying risk factors predisposing to gastrointestinal malabsorption (eg, celiac disease, inflammatory bowel disease, gastric bypass surgery) or dietary intake deficiency (eg, alcohol use disorder, restrictive eating disorder, vegan diet without supplementation). Incidence in the United States is estimated at approximately 0.056% in the general population.

Folate deficiency presents most commonly as a macrocytic anemia. In the United States, approximately 6% of macrocytic anemias are attributed to folate deficiency, which accounts for about 0.5% of all anemia. Pallor, fatigue, and oral ulcers are also observed in folate deficiency. In rare circumstances, folate deficiency can be associated with neuropathy, paresthesia, or neuropsychiatric symptoms. These are more typically seen in vitamin B12 deficiency, another cause of macrocytic anemia. Folate deficiency can develop quickly over a period of weeks to months as body stores are rapidly depleted with cell division and DNA synthesis.

Folate needs are increased in special populations and, if not proactively supplemented, folate deficiency can arise. These populations include patients with exfoliative skin disorders, hemodialysis dependence, or chronic hemolytic anemia, patients who are pregnant, and patients on certain medications (eg, methotrexate, sulfasalazine).

Codes

ICD10CM:
D52.9 – Folate deficiency anemia, unspecified

SNOMEDCT:
190633005 – Folic acid deficiency

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required

References

Subscription Required

Last Reviewed: 12/13/2018
Last Updated: 12/13/2018
Copyright © 2019 VisualDx®. All rights reserved.
Folate deficiency
Print 1 Images
Folate deficiency : Fatigue, Oral ulcers, Folate low, Hemolytic anemia, Infertility, Weight loss, Anorexia, Pallor
Copyright © 2019 VisualDx®. All rights reserved.