Biochemistry – Folate deficiency effects that can become life threatening – Biochemistry Club

Deficiency Manifestations of Folic acid

Free online Biochemistry lectures for Medical students by Biochemistry Club

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.

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.

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.

FOR COMPLETE LESSON, PLEASE VISIT VITAMINS CHAPTER IN BIOCHEMISTRY I, CLICK CURRICULUM TAB TO VIEW THE FULL LIST OF LESSONS,