Folate deficiency occurs due to…
- Inadequate dietary intake.
- Malabsorption: especially involving upper intestine— coeliac disease, tropical sprue, regional ileitis, etc.
- Biliary fistula; bile containing folate for recirculation is drained.
- Increased demand: pregnancy, lactation, rapid growth periods, haemolytic anaemia and other diseases with high cell turnover rates.
- Chronic alcoholism: intake of folate is generally poor. Moreover, its release from liver cells and recirculation are interfered.
- Megaloblastic anaemia, indistinguishable from that due to vit B12 deficiency. However, folate deficiency develops more rapidly if external supply is cut off.
- Epithelial damage: glossitis, enteritis, diarrhoea, steatorrhoea.
- Neural tube defects, including spina bifida in the offspring, due to maternal folate deficiency.
- General debility, weight loss, sterility. However, neurological symptoms do not appear in pure folate deficiency.
