Folic Acid deficiency
Definition & Clinical Appearance
Folic Acid is an essential vitamin for the production of red blood cells. As such, a deficiency in this vitamin can cause anaemia. A reduced number of red cells deprives body tissues of an adequate supply of oxygen, resulting in the classic symptoms of anaemia. The disorder is particularly common among infants, adolescents during a growth spurt, pregnant or lactating women, the elderly, smokers, alcoholics, and those on fad diets or who suffer from intestinal disorders. It can be accompanied by iron deficiency anaemia.
Signs and Symptoms
• Severe fatigue and weakness.
• Paleness (Pallor).
• Shortness of breath.
• Heart palpitations or noticeably rapid heartbeat upon exertion.
• Sore, red, and glazed-looking tongue.
• Loss of appetite leading to weight loss.
• Abdominal swelling.
• Nausea and diarrhea.
Aetiology
• Folic acid deficiency is due to either insufficient dietary intake of folic acid or, rarely, an inability of the intestine to absorb folic acid properly.
• Alcoholism interferes with the body’s ability to absorb and use folic acid. Many alcoholics also have poor diets lacking in folic acid.
• Intestinal disorders such as tropical sprue, celiac disease, inflammatory bowel disease, or bowel resection may impede folic acid absorbtion.
• The body does not store large amounts of folic acid, and at certain times in the life cycle (such as childhood, pregnancy, and when breastfeeding) the body’s demands for it outweigh dietary intake.
• Certain medications (such as anticonvulsants, antibiotics, oral contraceptives, and anticancer drugs) can lead to folic acid deficiency.
• Risk of folic acid deficiency increases in association with certain skin diseases, including psoriasis and exfoliative dermatitis.
Contributing Factors
Folic Acid deficiency
Start of Pathology / Onset
Onset is dependent on the relevant deficiency Location Red blood cells.
Complications
In pregnancy could cause neural defects in developing fetus.
Prophylaxis / Prevention
Eat a balanced, sensible diet. The main sources of folic acid include fresh green leafy vegetables, raw fruit, mushrooms, lima and kidney beans, yeast, and organ meats such as liver and kidney. Avoid overcooking foods rich in folic acid (overcooking destroys their vitamin content). Consume alcohol only in moderation. Prognosis Corrected by therapy.
Medical Treatment
Proper diet is frequently all that is required to correct the problem. Folic acid tablets can quickly correct the disorder. Depending on the cause of the deficiency, supplemental folic acid may be needed for a time, in rare instances, injections of folic acid are necessary. Elimination of causative factors (poor diet or excessive drinking) is essential. Treatment of an underlying intestinal disorder causing folic acid deficiency may serve as a cure.
Iron deficiency
Definition & Clinical Appearance
Iron deficiency anaemia occurs when the body’s usual stores of iron are so depleted that the bone marrow cannot produce enough hemoglobin, the iron-containing protein in red blood cells that carries oxygen in the bloodstream. Iron deficiency is the most common cause of anaemia, is rarely serious, and is easily treated in most cases. In fact, in mild chronic cases, it often produces few or no symptoms and is generally discovered only when a doctor obtains a complete blood count (CBC). Of course, more severe anaemia gradually leads to noticeable fatigue and other symptoms.
Signs and Symptoms
• Fatigue and weakness.
• Pallor (may be especially noticeable in the gums, eyelids, and nail beds).
• Heart palpitations, rapid heartbeat, or breathing difficulty, especially upon exertion.
• Irritability.
• Inability to concentrate.
• Smooth, sore tongue or tiny cracks at the corners of the mouth.
• Brittle nails.
• Black, tarry (or even bloody) stools (when anaemia is due to substantial blood loss in the gastrointestinal tract).
• Unusual craving (called pica) for clay, dirt, or ice.
Aetiology
The most common cause of iron deficiency anaemia is gradual, prolonged blood loss. For this reason, menstruating women are particularly prone to anaemia. In men, the most common cause of iron deficiency is blood loss in the digestive tract, resulting from disorders such as peptic ulcer, inflammatory bowel disease, and stomach or colon cancer. Sometimes haemorrhoids bleed enough to result in anaemia.
Contributing factors
Long-term use of aspirin (for heart attack prevention) or nonsteroidal anti-inflammatory drugs (such as ibuprofen and naproxen, sued for pain relief) can irritate the lining of the stomach and cause bleeding, resulting in anaemia. Pregnancy and breastfeeding increase the susceptibility of iron deficiency. Children with inadequate diet may also be at risk. In chronically ill patients, repeated blood drawing for diagnostic testing can produce an iron deficiency. Poor absorbtion of iron may result from surgical removal of the stomach (gastrectomy), from intestinal disorders that cause chronic diarrhea, or from abnormal food habits such as the ingestion of clay (stemming from unusual cravings known as pica), which can bind to iron. Intestinal bacteria or parasites such as hookworm can cause iron deficiency.
Location
Red blood cells.
Complications
Incorrect treatment (e.g. taking too much iron) can lead to heart and liver damage.
Prophylaxis / Prevention
Eat a balanced, sensible diet. Pregnant and menstruating women should discuss iron supplementation with their doctors. If you must regularly take aspirin or nonsteroidal anti-inflammatory drugs, take them with food or an antacid (one containing magnesium and aluminium hydroxide is best). Prognosis Iron deficiency anaemia is rarely serious and can be easily treated.
Medical Treatment
It is essential for a doctor to determine the underlying cause of an iron deficiency, and each case is treated based on the doctor’s conclusions. Iron supplementation may be required – but only under a doctor’s supervision. Taking too much iron unnecessarily can lead to excessive storage of iron and serious health problems, including heart and liver damage. Also, if you are losing blood due to a disease such as colon cancer, supplements might mask the problem and delay the diagnosis. If iron supplements are prescribed, be sure to take them for the full term recommended by your doctor, even if you begin to feel well again. After the anaemia is cured, your body needs to replenish its reserve stores of iron, which may take 3 months or more. Note that absorption of medicinal iron is decreased by mild and antacids. Iron may be given by intravenous injection in patients who cannot tolerate oral iron therapy. In very rare and severe cases, iron deficiency anaemia may be severe enough to require a transfusion of red cells.