After treating iron and vitamin B12 deficiency, next is folic acid deficiency, which takes its name from the Latin word 'folium' meaning leaf. They belong to the family of water-soluble B group vitamins and were first isolated from natural foods in 1943. Folic acid; It is an essential substance for the body, such as iron and vitamin B1212, and has important functions. In addition, folic acid deficiency occurs worldwide; It is more common than vitamin B12 and iron deficiency.
If we briefly mention the functions of folic acid in the human body:
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In the synthesis and repair of DNA, which is our building block
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In reducing the level of homocysteine, the high level of which creates the risk of embolism.
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In the synthesis of erythrocytes and leukocytes.
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Growth and development (especially in the womb)
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It plays a role in ensuring normal nerve development and brain functions.
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It plays a role in preventing the development of cancer and stroke. .
As we all know, it is very important for expectant mothers who are planning to become pregnant to start folic acid 2 months in advance in order to prevent neural tube defects. If there is no neural tube defect in a previous pregnancy or in the family, 400 micrograms of folic acid supplementation is sufficient, but if there is an individual with this disease, 5 mg folic acid should be used as a supplement during pregnancy. Of course, you can get detailed information from my gynecologist friends.
Clinical Findings in Folic Acid Deficiency:
-Clinical findings of anemia; weakness, fatigue, loss of appetite, extreme irritability and tension, paleness
-Neurological findings: depression, unhappiness, sensory loss, extreme restlessness, insomnia, restless leg syndrome, vision loss, loss of intellectual function, dementia and organic brain syndrome
-Gastrointestinal disorders: malabsorption, inability to gain weight, fatty stools
-Immunological findings: increased frequency of infections
-Cardiovascular ovascular findings: susceptibility to heart attack
Laboratory Findings:
-Complete blood count: Anemia In addition to low hemoglobin, which is an indicator, low leukocyte and platelet counts may also be observed.
-Peripheral smear: Erythrocytes are macrocytic, anisocytosis, poikilocytosis and fragmented erythrocytes may be seen. The presence of 5 or more 5-lobed nuclei or one 6-lobed nucleus in neutrophils is defined as hypersegmentation and is typical for B12 and folic acid deficiency.
-Blood biochemistry: Increase in indirect bilirubin level and LDH may be seen due to ineffective erythropoiesis.
-Serum folic acid level: Folic acid levels < 2ng/ml indicate definite deficiency. If possible, erythrocyte folate levels should be checked at values between 2-4 ng/ml.
-Serum homocysteine level: Folic acid level may be requested in the presence of normal but unexplained macrocytosis or neurological findings.
Treatment of folic acid deficiency
For a good treatment response, the following precautions should first be taken:
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Correction of folic acid deficiency
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Treatment of the underlying disease
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Nutrition with nutritional supplements that increase folic acid intake
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At regular intervals, patients Monitoring clinical conditions
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It is sufficient to give patients 1-5 mg/day folic acid orally daily. Treatment should be continued for 1-4 months or until hematological findings improve. B12 deficiency must be excluded before treatment.
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Foods rich in folate; Legumes, eggs, green leafy vegetables, beets, oranges, asparagus, hazelnuts, liver, brussels sprouts, bananas and avocados
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