Etiologies of Folate Deficiency
 • Decreased dietary intake - uncommon in this era
 • Increased requirements - Patients who are pregnant have hemolytic anemia, or psoriasis have increased needs for folate that can cause them rapidly to develop folate deficiency if intake is not kept up.
 • Malabsorption
 • Drugs - Patients with underlying mild folate deficiency are more susceptible to trimethoprim/sulfa, pyrimethamine and methotrexate toxicity. Oral contraceptive and anticonvulsants lead to increase consumption of folate.
 • Alcohol - Alcohol affects several aspects of folate metabolism. Alcoholics have a poor intake of folate. In addition, folate metabolism is interfered with leading to a functional folate deficiency. Alcoholics have an inability to mobilize folate stores and can have depleted tissue stores with normal serum levels of folate.

Dr. Thomas DeLoughery @Bloodman

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