Folic Acid Deficiency Follow-up

Updated: Jul 19, 2017
  • Author: Katherine Coffey-Vega, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Follow-up

Further Outpatient Care

Treat the underlying disease or condition causing folic acid deficiency.

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Deterrence/Prevention

Patients whose folic acid deficiency is related to dietary factors should be counseled to include green vegetables and fruit in their diet.

Prophylactic treatment of pregnant patients and patients with chronic hemolytic anemias can prevent folic acid deficiency due to the increased requirement for folate in these conditions.

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Complications

Note the following possible complications:

  • Megaloblastic anemia
  • Leukopenia
  • Thrombocytopenia
  • Angular stomatitis
  • Glossitis
  • Nausea and vomiting
  • Diarrhea
  • Hyperpigmentation
  • Low-grade fever
  • Elevated serum homocysteine
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Patient Education

Educate patients regarding proper nutrition, including eating fruits and vegetables. Educate patients regarding the need to reduce alcohol ingestion. Discuss the need to take folic acid supplementation.

Medical/legal pitfalls

Failure to provide folic acid supplementation to pregnant females may lead to spontaneous abortion and fetal abnormalities, including neural tube defects and increased risk of severe language delay in the child.

Providing only folic acid supplementation to a patient who has cobalamin deficiency may lead to development of irreversible neuropathies.

No randomized clinical trial has proven the efficacy of lowering the homocysteine concentration to improve cognition or to lower the incidence of cardiovascular disease (CVD). Until new evidence is available, clinicians should not promise patients that folate supplementation will improve cognition or decrease cardiovascular risk.

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