Folic acid (synonyms: folate, pteroylglutamic acid, vitamin B9, vitamin M) is a vitamin assigned to the vitamin B complex. It is one of the essential nutritional components, i.e. these are essential for life, as the body cannot produce them itself.The active metabolite of folic acid is tetrahydrofolic acid. Folic acid is found mainly in milk, animal liver, yeast and green plants. Folic acid is important primarily for blood formation, but also as a coenzyme for various metabolic processes such as the methylation of homocysteine to methionine, and purine and pyrimidine synthesis.
The process
Material needed
- Blood serum
Preparation of the patient
- Observe strict dietary abstinence for twelve hours before blood collection.
Interfering factors
- Not known
Standard values
| Normal value in ng/ml | > 2,5 |
| Manifest deficiency | < 2,0 |
Indications
- Alcoholism
- Dermatitis – inflammatory reaction of the skin that primarily affects the dermis (leather skin).
- Glossitis (inflammation of the tongue)
- In the course of pregnancy – in multiple pregnancies.
- Increased erythopoiesis – increased formation and development of erythrocytes (red blood cells).
- Long-term hemodialysis (“blood washing”).
- Psoriasis (psoriasis)
- Stomatitis (inflammation of the oral mucosa)
- Suspected hyperchromic macrocytic anemia (megaloblastic anemia) – anemia caused by a deficiency of vitamin B12 or, less commonly, folic acid deficiency.
- Long-term therapy with folic acid antagonists (such as methotrexate) or antiepileptic drugs such as carbamazepine.
Interpretation
Interpretation of lowered values
- Alimentary (nutritional)
- Unilateral nutrition (parenteral nutrition)
- Chronically high alcohol and nicotine consumption
- Malabsorption (disorder of absorption)
- Maldigestion (disorder of digestion).
- Chronic digestive insufficiency such as celiac disease (gluten-induced enteropathy; chronic disease of the small intestinal mucosa (lining of the small intestine) due to hypersensitivity to gluten, a grain protein)
- Diseases that may be associated with decreased serum folic acid levels:
- Hyperchromic macrocytic anemia (megaloblastic anemia).
- Exfoliative dermatitis – skin inflammation associated with extensive scaling.
- Leukemia (blood cancer)
- Psoriasis (psoriasis)
- Tumors, unspecified
- Condition after resection of the small intestine – removal of a section of the small intestine.
- Long-term hemodialysis (“blood washing”).
- Medication
- Taking oral contraceptives (pill)
- Antiepileptic drugs – drugs for epilepsy such as carbamazepine.
- Folic acid antagonists such as methotrexate, sulfasalazine, sulfonamides, trimethoprim
- Increased demand
- Growth
- Pregnancy/breastfeeding phase; especially women with multiple pregnancies – due to increased maternal blood volume as well as multiplied fetal requirements
- Pregnancies occurring at short intervals in succession – the mother does not have enough time to replenish the depleted folic acid stores
- Pregnancy at a young age – folate stores are inadequately filled after the growth spurt of puberty; inadequate folate supply during pregnancy increases the risk of preterm birth, low birth weight, fetal growth retardation and the occurrence of neural tube defects
- Low socioeconomic status or low dietary patterns – mostly low folic acid diet.
- Age > 60 years
Further notes
- The normal requirement for folic acid in women and men is 400 µg/d.
Attention!Note on the state of supply (National Consumption Study II 2008)79% of men and 86% of women do not reach the recommended daily intake.The undersupply increases with increasing age of men and women.
