- Function
- Converted to tetrahydrofolic acid (THF), a coenzyme for 1-carbon transfer/methylation reactions.
- Important for synthesis of nitrogenous bases in DNA and RNA.
- Found in leafy green vegetables, produced by gut microbiota. Folate absorbed in jejunum (think foliage in the "jejun"gle).
- Small reserve pool stored primarily in the liver.
- Deficiency
- Macrocytic, megaloblastic anemia; hypersegmented polymorphonuclear cells (PMNs); glossitis; no neurologic symptoms (as opposed to vitamin B₁₂ deficiency).
- Labs: increased homocysteine, normal methylmalonic acid levels. Seen in chronic alcohol overuse and in pregnancy.
- Can be caused by several drugs (phenytoin, trimethoprim, methotrexate).
- Supplemental folic acid at least 1 month prior to conception and during pregnancy to decrease risk of neural tube defects. Give vitamin B₉ for the 9 months of pregnancy, and 1 month prior to conception.
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