Folic Acid Deficiency Anemia

Folic acid deficiency anemia, a lack of red blood cells, is not as common in the United States as it once was. With medical advances and easy access to folic acid-rich foods, most pregnant women in the U.S. can easily avoid deficiency as long as they are informed on how it occurs and how to avoid it. Although rare, folic acid deficiency still occurs, and if left untreated, can lead to medical issues for both mother and baby.

What is Folic Acid Deficiency?

Folic acid deficiency, also referred to as folate deficiency, is a term defined as low levels of folic acid in the body. Women can become deficient when there is not enough folic acid in their system. This can usually be remedied by eating a variety of foods that contain folic acid and/or by taking folic acid supplements. Almost all prenatal vitamins contain folic acid. Since the body doesn’t store folic acid, it has to be restored daily, or the risk of deficiency occurs.

Folic acid deficiency anemia happens when the body doesn’t have enough folic acid to produce red blood cells. Folic acid is a B vitamin that the body needs in order to produce red blood cells to carry oxygen to all parts of the body. Without this important nutrient, women can become anemic or the baby can be at risk for a neural tube defect (spinal bifida).

What Causes Folic Acid Deficiency Anemia?

Folic acid deficiency can occur at any time, yet it typically occurs while pregnant. During pregnancy, the folic acid in the mother’s body is first used to support the growing infant, and if there isn’t enough leftover, the mother may become deficient.

Other medical conditions associated with folic acid deficiency include Crohn’s disease, thalassemia, celiac disease, and sickle cell anemia.  Morning sickness has also been linked to some cases of folic acid deficiency, especially when pregnant women experience daily vomiting.

How to Prevent Folic Acid Deficiency

Doctors and pediatricians should recommend that pregnant and nursing mothers eat plenty of broccoli, spinach, sprouts, green beans, peas, chickpeas, brown rice, liver, kidneys and potatoes.

For breakfast and snacks, a variety of folic acid-rich foods include fortified cereal, bananas, oranges and bread. In fact, according to the Centers for Disease Control and Prevention (CDC), one bowl of  folic acid-fortified cereal will give women the amount of folic acid needed each day.

However, the University of Maryland Medical Center (UMMC) suggests that pregnant women should take extra folic acid each day to accommodate a growing baby. For example, an adult female who isn’t pregnant should get at least 400 mcg of folic acid each day, while a pregnant woman should get at least 600 mcg. Women who are breastfeeding should get 500 mcg per day.

Doctors recommend preparing leafy greens, broccoli and green beans by steaming rather than frying. Most of these foods have a higher level of folic acid if they are steamed in a proper food steamer because this preserves as many vitamins in the food as possible. A well-balanced diet should already contain all of these essential vitamins, but if you’re recovering from folic acid deficiency, these foods are especially important.

Symptoms of Folic Acid Deficiency Anemia

Anemia symptoms are due to a reduced amount of oxygen to the body. In turn, many women will experience oxygen deprivation symptoms such as:

• Extreme tiredness
• Breathlessness
• Feeling faint
• Headaches
• Heart palpitations
• Tinnitus
• Pale appearance

Treatment of Folic Acid Deficiency Anemia

For adults, doctors recommend taking folic acid tablets for up to four months until the anemia resolves. For patients who have sickle cell disease, they may have to take the folic acid tablets indefinitely. Also, babies born with folic acid deficiency anemia should be carefully assessed by a doctor.

Treatment for babies with this condition could range anywhere from a special diet to treating any defects or injuries caused by folic deficiency, such as physical therapy, medication and more, depending upon the injury.

Prognosis for Infants

According to the American Journal of Clinical Nutrition, infants who are deficient in folic acid are at a heightened risk for a number of medical complications, including:

• Low birth weight
• Neural tube defects
• Nervous system damage
• Stillbirth
• Brain damage

Therefore, it is important to address any signs of folic acid deficiency in pregnant women, nursing mothers and infants.

Page Medically Reviewed By Stephanie Baumhover, PharmD, BCPS

Stephanie Baumhover, PharmD, BCPS, is a skilled pharmacist with experience in medical information, communications, critical care, pediatrics and managed care. She is a skilled medical writer, and is a regular medical reviewer for Birth Injury Guide.

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