Anemia due to folic acid deficiency can express itself in different ways. After compensation of a folic acid deficiency by longer-term folic acid intake, occurring symptoms usually regress.
What is anemia due to folic acid deficiency?
If an affected person has anemia due to folic acid deficiency, it means that there are too few red blood cells (erythrocytes) in that person’s blood or that the blood has too little red blood pigment (hemoglobin). In anemia due to folic acid deficiency, among other things, not enough oxygen can be transported from the air we breathe to the areas of the body where oxygen is needed for the purpose of energy production. Anemia due to folic acid deficiency is in most cases associated with typical symptoms. These possible symptoms of anemia due to folic acid deficiency include, for example, fatigue, dizziness, pallor, palpitations, concentration problems or ringing in the ears. In addition, anemia due to folic acid deficiency may result in symptoms such as impaired gastrointestinal tract, diarrhea, or an altered sense of taste.
Causes
Anemia due to folic acid deficiency may initially occur because folic acid is needed to form red blood cells. If there is now insufficient folic acid in the body, the production of red blood cells may be impaired and anemia due to folic acid deficiency will result. An undersupply of folic acid, which can lead to anemia, has various possible causes: First, a folic acid deficiency can be caused, for example, by a diet too low in folic acid. Such a diet is more common in people who are addicted to alcohol or drugs, or in older people. Anemia due to folic acid deficiency can also be caused by an individually increased need for folic acid; this is the case, for example, in pregnant women or growing adolescents. Long-term use of certain medications can also cause anemia due to folic acid deficiency.
Symptoms, complaints, and signs
Anemia due to folic acid deficiency can manifest itself through a variety of symptoms. Most often, those affected experience increasing fatigue as well as dizziness and shortness of breath. In the cardiovascular system, anemia is manifested by palpitations] and occasionally by stabbing pain. In the further course, cardiac arrhythmias and other symptoms may occur. Typical is also ringing in the ears, which is sometimes associated with impaired hearing. Externally, folic acid deficiency anemia is manifested by pallor, especially on the eyelids, gums and the inner sides of the lips. Due to the regression of the oral mucosa, there are tears in the corners of the mouth. Occasionally, bleeding and edema also occur. The tongue appears reddish to smooth and the sense of taste is weakened. Some patients also experience gastrointestinal symptoms such as diarrhea, stomach pressure, and [[indigestion. In severe cases, there may be headaches, pain in the limbs – especially in the legs – and tachycardia. Chronic anemia can also manifest itself through psychological complaints, for example mood swings and depression. Affected newborns often suffer from malformations and mental disorders. A strikingly pale facial color is typical, which often persists long after the deficiency has been corrected.
Diagnosis and course
Anemia due to folic acid deficiency can be diagnosed initially with the aid of a blood test: the red blood cells contained in the blood sample are examined microscopically if anemia due to folic acid deficiency is suspected; an enlargement of the red blood cells is indicative of a folic acid deficiency or anemia. To ensure that anemia is due to folic acid deficiency, a treating physician can also specifically test the blood sample taken for folic acid deficiency. As a rule, anemia can be successfully controlled by adjusting an affected person’s intake of folic acid amounts to his or her individual needs. Once the folic acid deficiency as the cause of anemia has been eliminated in the long term, possible symptoms that can accompany anemia usually recede as well.
Complications
The diagnosis of anemia due to folic acid deficiency must be conscientiously considered. Acute deficiency of hemoglobin cuts off oxygen transport from the lungs to the tissues.As a result, the body becomes fatigued and various negative side effects significantly affect the quality of life. Folic acid is an important carrier for the production of red blood cells. Anyone suffering from folic acid deficiency should regularly take a supplement. If the symptoms are not treated in time or not treated at all, troublesome accompanying symptoms occur in everyday life. Restrictions such as permanent fatigue and dizziness can have a detrimental effect on working life. Emotionally unstable patients are more at risk of depression. Stressed individuals are prone to palpitations, angina pectoris, and significant leg pain. If blood loss has become chronic, the condition of dialysis patients can worsen in a life-threatening manner. The highest risk groups are women, children and adolescents. During menopause, there is a risk of hair loss and extreme mood swings. In pregnancy, unrecognized anemia due to folic acid deficiency leads to severe malformations of the fetus such as cleft lip and palate and open back. Folic acid deficiency can also adversely affect healthy growth in adolescents, especially girls during the menstrual phase. Anemia in elderly patients increases the risk of atherosclerosis and adversely affects the function of organs, especially the kidneys.
When should you see a doctor?
Anemia caused by deficiencies in the supply of folic acid belongs immediately to medical treatment. Although the symptoms do not appear immediately as in the case of rapid blood loss, they are still no less dangerous. Pregnant women in particular suffer more frequently from this particular form of anemia due to their increased folic acid requirement. Since pregnant women attend regular check-ups by their doctor anyway, an additional examination to check the vitamin B9 level should be carried out if there are the slightest signs. Concrete suspicions arise in the case of a long-term unbalanced diet, which can trigger a folic acid deficiency. In the case of frequent attacks of daytime fatigue, physical and mental performance decline with shortness of breath, a visit to the doctor for clarification is advisable in any case. Unusually heavy perspiration during light activities as well as a flat pulse may indicate a deficit of red blood cells for oxygen transport. Sudden tachycardia requires immediate clarification by a specialist. Severe forms of anemia due to folic acid deficiency trigger dizziness up to a complete loss of consciousness. In the much more common, insidious form of anemia due to an undersupply of folic acid, the first warning signs occur sporadically and subside spontaneously. The body is able to compensate for and tolerate a slow decline in red blood cells over a longer period of time. Those affected are usually unaware of the underlying causes and usually suffer primarily from recurrent fatigue. In general, all regularly occurring warning signs of anemia without a clear cause give reason to consult the family doctor. The deficiency state always leads to potentially life-threatening conditions in the long term.
Treatment and therapy
The goal of therapy for anemia due to folic acid deficiency is first to address the causes that led to the anemia. Therefore, if there are signs of anemia, it may be important to consult a physician to determine the individual causes of anemia. If, for example, addictive disorders are the underlying cause, an important component in combating the anemia can initially be therapeutic treatment of the addiction problem. If it has been possible to positively influence a dependency disorder within the framework of therapeutic treatment, this often subsequently also influences the folic acid balance in the body and thus the disease. If an affected person is anemic due to folic acid deficiency because the individual requirement has increased, increased folic acid can be obtained, for example, through a conscious diet: Green vegetables, oatmeal, asparagus, liver or mushrooms are very rich in folic acid and therefore effective against anemia. If necessary, supplements containing folic acid can be taken to combat anemia after consulting a physician.
Outlook and prognosis
Incurred anemia due to folic acid deficiency is associated with a good prognosis.If those affected go to the doctor due to the onset of symptoms and the doctor diagnoses a correspondingly conditioned anemia, the administration of folic acid preparations is sufficient for acute treatment. If the diet is changed to a folic acid-containing diet in the long term, relapses are no longer to be expected. The affected person is completely cured of his symptoms and the blood count normalizes. On the other hand, the affected person is more dependent on folic acid supplements if he or she has a metabolic disease or other illness that impedes the absorption of nutrients. The corresponding losses in metabolism must then be absorbed all the more artificially. Treatment of the causes should also be carried out so that these measures can also be reduced in the long term and a balanced diet is sufficient. Pregnant women who have anemia due to folic acid deficiency should react particularly quickly, since a folic acid deficiency also affects the development of the child. The main concern here is the increased risk of spina bifida formation. If left untreated, the anemia caused by folic acid deficiency will rarely be fatal, but the debilitating symptoms can severely limit the quality of life of the affected individual.
Prevention
Prevention of anemia due to folic acid deficiency is primarily through a varied diet rich in folic acid. A healthy lifestyle and largely abstaining from addictive substances also contribute to a balanced folic acid balance. If folic acid requirements are very high, dietary supplements can help prevent anemia due to folic acid deficiency after seeking medical advice.
Follow-up
Depending on what caused the anemia due to folic acid deficiency, follow-up care may need to be more or less intensive and ongoing. For example, if the folic acid deficiency anemia is caused by chronic alcohol consumption or is age-related, the conditions may be more complex than if there is an increased need for folic acid or a malabsorption syndrome. Often, the circumstances of folic acid deficiency with subsequent anemia are such that further treatment and follow-up are required in addition to correcting the folic acid deficiency. Follow-up care in the elderly consists of oral folic acid substitution. In the case of chronic alcoholism, rehab must be ordered. Nutritional status should be reviewed and improved in both cases. In the case of increased folic acid consumption by pregnant women or an additional need for folic acid due to chronic hemolysis, follow-up includes a regular presentation to the attending physician. Oral folic acid substitution is performed. Malabsorption syndromes such as celiac disease require a gluten-free diet with increased folic acid content. In this case, follow-up care must ensure that the gluten intolerance has not caused damage to the digestive tract. Regular monitoring is advisable. In the case of folic acid deficiency anemia due to medications, their replacement must be considered. In addition, folic acid substitution must be performed. Either way, anemia due to folic acid deficiency must be taken seriously. Close monitoring is especially important in pregnant women.
Here’s what you can do yourself
Anemia due to folic acid deficiency can be managed with a change in diet to fresh foods. The daily amount of folic acid should be at least 0.4 mg. Vegetables such as leaf spinach, fennel, Chinese cabbage, and radishes and beets are excellent choices. Mushrooms, broccoli, beans and asparagus are also rich in folic acid. Care should be taken to ensure gentle preparation. It is best to steam or use the low-cooking method so that the valuable ingredients are not lost. When it comes to fruit, fresh oranges should be part of the daily menu. For example, as freshly squeezed juice or in a delicious fruit salad. When it comes to meat, the choice should go to cooked liver and beef. Other foods with a high folic acid content include oatmeal, yeast, nuts, and cow’s and mother’s milk. To prevent expected offspring from developing folic acid deficiency, folic acid should be taken in combination with vitamin B supplements at least four weeks before pregnancy. To protect the mother, it is also recommended to continue taking it for eight weeks after delivery. Alternatively, or as a supportive measure, folic acid requirements can also be met with appropriate dietary supplements. However, this should be done in consultation with a doctor or nutritionist.
