Not consuming enough foods rich in folate, such as leafy greens, citrus fruits, nuts, beans, and whole grains, is a common cause.
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- **Alcohol Consumption**: Excessive alcohol intake can impair the absorption of folate[3][4].
- **Digestive Disorders**: Conditions like celiac disease can affect the absorption of folate in the digestive tract[3][4].
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**Medications**: Certain medications can interfere with folate absorption[3][4].
Several medications can interfere with the absorption of folate (vitamin B9) in the body. These include:
1. **Anticonvulsants**: Medications such as phenytoin, fosphenytoin, phenobarbital, and primidone, which are used to treat epilepsy, may reduce folate levels[1][2][3].
2. **Methotrexate**: This medication, used for treating cancer, rheumatoid arthritis, and psoriasis, reduces the body's folate levels. Higher doses of folic acid may be prescribed to mitigate side effects, but only under medical supervision, especially for cancer patients[1][3][5].
3. **Antibiotics**: Tetracycline, in particular, should not be taken simultaneously with folic acid as it can interfere with the absorption and effectiveness of the antibiotic[1][3].
4. **Antacids and Indigestion Remedies**: Antacids containing aluminum or magnesium can prevent folic acid from being properly absorbed if taken within two hours of each other[3].
5. **Bile Acid Sequestrants**: Cholesterol-lowering medications like cholestyramine, colestipol, and colesevelam can reduce folate levels[1][3].
6. **Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)**: These can increase the body's need for folic acid when used for extended periods[1].
7. **Sulfasalazine**: Used for treating inflammatory bowel conditions, this medication can interfere with folate absorption[1][3].
8. **Triamterene**: This diuretic acts as a folate antagonist, potentially leading to folate deficiency[1][5].
These interactions can lead to decreased folate levels, necessitating additional folic acid supplementation, but only under the guidance of a healthcare provider.
Citations:
[1] https://www.stlukes-stl.com/health-content/medicine/33/000993.htm
[2] https://www.mayoclinic.org/drugs-supplements-folate/art-20364625
[3] https://www.nhs.uk/medicines/folic-acid/taking-folic-acid-with-other-medicines-and-herbal-supplements/
[4] https://www.drugs.com/drug-interactions/folic-acid.html
[5] https://pubmed.ncbi.nlm.nih.gov/3896745/
### Symptoms
The symptoms of folic acid deficiency can include:
- Fatigue and weakness
- Mouth sores
- Neurological issues such as depression or confusion
- Anemia, characterized by the production of abnormally large red blood cells that do not function properly[1][2][3][4].
### Complications
Folic acid deficiency can lead to serious complications, especially during pregnancy. These include:
- Neural tube defects such as spina bifida and anencephaly in the developing fetus[1][3][4].
- Increased risk of placental abruption and preterm birth[1][4].
- Potential long-term health issues, including problems with the nervous system and increased risk of heart disease[2][4].
### Diagnosis and Treatment
Folic acid deficiency is diagnosed through blood tests that measure folate levels. Treatment typically involves dietary changes to include more folate-rich foods and may also include folic acid supplements. In some cases, treating underlying conditions that affect folate absorption is necessary[1][2][3][4].
### Prevention
Preventing folic acid deficiency involves maintaining a balanced diet rich in folate and, for pregnant women, taking folic acid supplements as recommended by healthcare providers[1][4].
Citations:
[1] https://my.clevelandclinic.org/health/diseases/22198-folate-deficiency
[2] https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/
[3] https://www.hopkinsmedicine.org/health/conditions-and-diseases/folate-deficiency-anemia
[4] https://www.webmd.com/a-to-z-guides/folic-acid-deficiency-anemia
[5] https://medlineplus.gov/ency/article/000354.htm