Special Precautions/Comments:

Additional Information:

Deficiency of folate can be a result of liver diseases, impaired folate metabolism due to genetic defects or drug interactions, decreased nutritional intake, poor absorption of ingested folate in the intestine or increased demand of folate, for example during physical activity or pregnancy.

Folate is essential for foetal development, and guidelines recommend women that are pregnant or are planning to become pregnant to take folic acid supplements to prevent foetal malformations such as neural tube defects, but also other pregnancy complications such as preeclampsia. If not supplemented during pregnancy and lactation, folate levels decrease in both plasma and RBC.

A clinical manifestation of both folate and vitamin B12 deficiency is the so called megaloblastic (macrocytic) anaemia: due to the affected DNA synthesis and cell maturation, especially involving the cells of erythropoiesis, the total count of erythrocytes is significantly reduced. The haemoglobin synthesis capacity however is normal, which leads to abnormally large erythrocyte precursors (“macrocytes” or “megaloblasts”), which have an elevated haemoglobin content (“hyperchromic anemia”). Because vitamin B12 and folate are closely interrelated in the cellular one carbon-unit metabolism, and also haematologic and clinical consequences of the two vitamin deficiency states might be similar, it is advisable to determine both parameters simultaneously in patients with the relevant symptoms of vitamin-deficiency.