In the early stages of folic acid deficiency, physical symptoms are absent, but an increase in serum homocysteine levels in the blood may already be evident.
Folic acid deficiency affects rapidly dividing cells in particular. Therefore, deficiency symptoms appear especially in the blood picture, because blood cells are formed from rapidly dividing cells of the bone marrow:This explains why anemia occurs in the case of a deficiency. This type of anemia is called megaloblastic or macrocytic anemia because the blood cells are abnormally large (megaloblasts). In addition to the erythrocytes (red blood cells), the leukocytes (white blood cells) – which also originate in the bone marrow – are also affected and show hypersegmentation of the nuclei, which is characteristic of megaloblastic anemia. Progression of the anemia then leads to the classic symptoms of fatigue, weakness, and in extreme cases, shortness of breath.
Notice.
Megaloblastic anemia resulting from folic acid deficiency is clinically and microscopically identical to anemia caused by vitamin B12 deficiency. It is therefore important to treat such anemia not only with folic acid but also with vitamin B12 to prevent neurologic damage.
