Folate deficiency

Screening for folate deficiency is not routinely recommended. However, in patients with diseases that are associated with folate deficiency, early detection can lead to folic acid supplementation, which is a simple correction of the underlying cause. Supplementation can prevent the development of megaloblastic anemia and fetal neural tube defects.

At-risk populations

Certain populations are at increased risk of developing deficiency:

• Low socioeconomic groups with poor nutrition

• Older people with poor dietary intake

• People who misuse alcohol

• Pregnant or lactating women and preterm infants

• People with chronic hemolytic anemia or chronic exfoliative dermatitis

• People taking drugs that interfere with folate absorption and metabolism

• People with hereditary folate malabsorption and inborn errors of folate metabolism

• People with chronic diarrheal states and other intestinal disorders

• Chronic peritoneal dialysis patients

• Infants who are fed goats' milk exclusively, and children with inborn errors of metabolism given a synthetic diet.

Screening tests

Complete blood count (CBC) may show increased mean corpuscular volume with or without low hemoglobin. This result triggers further testing for causes of macrocytosis, which includes serum folate level. At-risk populations are tested in general for folate deficiency if the CBC is abnormal.