Deficiency Manifestations of Folic acid
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1. Reduced DNA synthesis
- In folate deficiency, the enzyme thymidylate synthase is inhibited due to reduced THFA.
- Cell division is arrested. Very rapidly dividing cells in bone marrow and intestinal mucosa are most seriously affected.
2. Macrocytic anemia
- The most characteristic feature of Folate deficiency is Macrocytic anemia.
- During RBC generation, DNA synthesis is delayed, but protein synthesis is continued.
- Thus hemoglobin accumulates in RBC precursors.
- This asynchrony or dissociation between the maturity of nucleus and cytoplasm is manifested as immature looking nucleus and mature eosinophilic cytoplasm in the bone marrow cells.
- Reticulocytosis is often seen. These abnormal RBCs are rapidly destroyed in spleen.
- Hemolysis leads to the reduction of lifespan of RBC.
- Reduced generation and increased destruction of RBCs result in anemia.
- Leukopenia and thrombocytopenia are also manifested.
- The peripheral blood picture in folate deficiency is described as macrocytic, and in Cobalamin deficiency as megaloblastic.
- In Vitamin B12 (Cobalamin) deficiency, there are additional neurological symptoms.
- Increased homocysteine levels in blood in Folate deficiency since the remethylation of homocysteine is affected.
- Plasma homocysteine levels above 15 mmol/L is known to increase the risk of coronary artery diseases.
- Providing adequate doses of pyridoxine, B12 and folic acid may lower the homocysteine levels.
4. Birth defects
- Folic acid deficiency during pregnancy may lead to neural tube defects in the fetus.
- Folic acid prevents hyperhomocysteinemia and therefore neural tube defects like spina bifida.
- Therefore, intake of folic acid is a must from early pregnancy.
- Folic acid is beneficial in prevention of …
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