Definition of Folate-deficiency anemia:

Folate-deficiency anemia is a decrease in red blood cells (anemia) due to a lack of folate.

Causes, incidence, and risk factors:

Folate, also called folic acid, is necessary for red blood cell formation and growth. You can get folate by eating green leafy vegetables and liver. Some medications, such as phenytoin (Dilantin), interfere with the absorption of this vitamin. Because folate is not stored in the body in large amounts, a continual dietary supply of this vitamin is needed to maintain normal levels.

In folate-deficiency anemia, the red cells are abnormally large. These large cells are called megalocytes, or megaloblasts in the bone marrow. That is why this anemia can also be called megaloblastic anemia.

Causes of this anemia are:

• Certain medications
• Diseases such as celiac disease (sprue), which reduce absorption of folic acid from the diet
• Poor dietary intake of folic acid

In the third trimester of pregnancy, a woman may have a deficiency due to an increased need for folic acid. Hemolytic anemia can also cause a deficiency due to increased red blood cell destruction.

Risk factors include:

• Alcoholism (which interferes with the absorption of folate)
• Eating overcooked food
• History of malabsorption diseases
• Poor diet (often seen in the poor, the elderly, and people who do not eat fresh fruits or vegetables)
• Pregnancy

The disease occurs in about 4 out of 100,000 people.