Folate Deficiency
OVERVIEW
- pterin ring connected to PABA
- active form = THFA
- 500-20,000 mcg stored in body
- required 50-100mcg/day
- required for DNA, RNA and protein synthesis (purine, thymidine and amino acid synthesis)
CAUSES
- inadequate intake (alcoholics, diet, starvation, elderly, renal and liver failure)
- decreased absorption (intestinal disease, coeliacs, Dilantin use, zinc deficiency)
- impaired metabolism (methotrexate, trimethoprim)
- increased consumption (infants, pregnancy, lactation, fever, malignancy)
- increased excretion (Vit B12 deficiency, alcoholism, dialysis)
- increased destruction (smoking)
CLINICAL FEATURES
- manifests after 4 months
- macrocytic anaemia
- hypersegmented PMN’s
- peripheral neuropathy
- deficiency -> increased incidence of neural tube defects, ?increased cancer
MANAGEMENT
- oral supplementation
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC