nutritional disorders
Folate Deficiency
Etiology of Folate Deficiency
The most common causes of folate deficiency are Inadequate intake (usually in patients with Overview of Undernutrition or Increased demand (eg, due to pregnancy or lactation) Overview of Malabsorption (eg, in Deficiency can also result from inadequate bioavailability and increased excretion (see table). Prolonged cooking destroys folate, predisposing to inadequate intake. Intake is sometimes barely adequate (eg, in people with alcohol use disorder). Liver stores provide only a several-month supply. Alcohol interferes with folate absorption, metabolism, renal excretion, and enterohepatic reabsorption and reduces healthy food intake. 5-Fluorouracil,metformin,methotrexate,phenobarbital,phenytoin,triamterene, andtrimethoprimimpair folate metabolism. In the US and Canada, many dietary staples (eg, cereals, grain products) are routinely enriched with folate, tending to reduce risk of deficiency. 