4. Folic Acid Anemia

what is folic acid needed for?

DNA production and erythropoiesis + formation of fetal neural tube

• only from diet

what are common causes of folic acid deficiency?*

• impaired dietary intake

• chronic alcohol use disorder*

• small bowel disease or malabsorption syndrome

• hemodialysis

• older age

which patients have higher folic acid requirements?

• patients with liver disease

• patients with chronic hemolytic anemias

• patients who are pregnant or of child-bearing age

what key finding distinguishes folic acid deficiency from B12 deficiency?*

no neurologic findings

how is folic acid deficiency usually treated?

• oral supplements

• IM injections (for malabsorption syndrome)

• increasing intake

when can folic acid be given IM?

for malabsorption syndromes

what foods are high in folate?*

• liver

• green leafy vegetables

• citrus fruits and juices

• legumes (peas, nuts, beans)

what diet teaching is important in folic acid deficiency?

• choose soft, bland foods if the mouth or tongue is sore

• eat foods high in vitamin B9

• avoid alcohol

what important teaching is needed about large doses of folic acid?*

• urine can turn dark yellow

• folic acid can mask vitamin B12 deficiency