Folate deficiency

Prognosis and outcome of folic acid therapy

In acquired folate-deficient megaloblastic anaemia, daily folic acid supplementation brings about haematological remission and replenishes body stores within approximately 4 months.[76]National Institute for Health and Care Excellence. BNF for children treatment summaries. Anaemia, megaloblastic. 2019 [internet publication]. https://bnfc.nice.org.uk/treatment-summary/anaemia-megaloblastic.html  

Continued folic acid supplementation

Patients with ongoing folate loss (e.g., malabsorption disorders, chronic haemolytic anaemia, exfoliative dermatitis) and those with a continued state of increased demand (e.g., pregnancy, lactation, prematurity) require continued supplementation of folic acid.

Because these patient groups are at risk for recurrence of folate deficiency, and for masking of underlying vitamin B12 (cobalamin) deficiency with folic acid therapy, it is advisable to monitor such patients periodically for folate and vitamin B12 deficiencies.

Risk factor avoidance

Alcohol, other drugs, and toxins that lead to folate deficiency should be avoided.

Dietary modification

Patients should include foods rich in folate.[63]Cordero JF, Do A, Berry RJ. Review of interventions for the prevention and control of folate and vitamin B12 deficiencies. Food Nutr Bull. 2008 Jun;29(2 suppl):S188-95. http://www.ncbi.nlm.nih.gov/pubmed/18709892?tool=bestpractice.com Alternatives include consuming foods fortified with folic acid or supplementing folate through multivitamin intake.