Supplementation with a multivitamin containing 800 µg of folic acid shortens the time to reach the preventive red blood cell folate concentration in healthy women

2009 ◽  
Vol 79 (2) ◽  
pp. 61-70 ◽  
Author(s):  
Susanne Brämswig ◽  
Reinhild Prinz-Langenohl ◽  
Yvonne Lamers ◽  
Oliver Tobolski ◽  
Eva Wintergerst ◽  
...  
Keyword(s):  
Folic Acid ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Daily Intake ◽  
Threshold Level ◽  
Time Frame ◽  
Folic Acid Supplementation ◽  
Current Recommendation ◽  
Folate Concentration ◽  
Over Time

Background: The lowest risk of having a child with a neural tube defect (NTD) was related to red blood cell (RBC) folate concentrations of >906 nmol/L. For NTD prevention, it is recommended that women use periconceptional supplementation of 400 µg/day folic acid. Using this dose previous studies indicate that RBC folate >906 nmol/L was not reached within four weeks of supplementation. Objective: The effectiveness of a multivitamin/multimineral supplement containing 800 µg folic acid (verum) was evaluated using RBC folate concentration exceeding 906 nmol/L as primary endpoint. In addition, the time frame of achieving the threshold level was established as well as the effect of supplementation of other B vitamins on folate metabolism. Subjects and Methods: 46 healthy females received 800 µg/day of folic acid or placebo for 16 weeks. Blood samples were collected in four-week intervals. Plasma and RBC folate were measured with the microbiological method. Results: Mean (±SED) RBC folate increased over time to 1430±53 nmol/L, but did not reach a steady state after 16 weeks of intervention. Mean time to reach the target level was 4.2 ± 3.5 weeks in the verum group. Intake of verum also led to an increase over time of plasma folate. Conclusions: Preventive RBC folate concentration of more than 906 nmol/L can be reached within four weeks of supplementation with daily intake of 800 µg folic acid. With respect to NTD prevention, we suggest the re-evaluation of the current recommendation of folic acid supplementation.

Diminished Need for Folate Measurements Among Indigent Populations in the Post Folic Acid Supplementation Era

2007 ◽  
Vol 131 (3) ◽  
pp. 477-480
Author(s):  
Dean W. Joelson ◽  
Eberhard W. Fiebig ◽  
Alan H. B. Wu
Keyword(s):  
United States ◽  
Folic Acid ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Rare Event ◽  
Folate Deficiency ◽  
The United States ◽  
Folic Acid Supplementation ◽  
Folate Concentration ◽  
Using Data

Abstract Context.—The mandated fortification of processed grains with folic acid in the United States and Canada in 1998 was intended to reduce the incidence of neural tube defects in pregnant women. The incidence of folate deficiency in most populations has declined dramatically since then. Objective.—To determine the rate of folate deficiency in a cohort of indigent patients, a population among those at highest risk for folate deficiency. Design.—Using data from 3 years (1997, 2000, and 2004), we examined results of laboratory tests for red blood cell folate ordered at 3 hospitals that predominately service the needs of indigent patients. Folate concentration cutoffs were 160 ng/mL (363.6 nmol/L) and 94 ng/mL (213 nmol/L). Results.—Using a red blood cell folate cutoff concentration of 160 ng/mL (363.6 nmol/L), the combined incidence of folate deficiency decreased from 4.8% in 1997 to 0.6% in 2004. At a cutoff of 94 ng/mL (213 nmol/L), the incidence went from 0.98% to 0.09% in 1997 and 2004, respectively. Even when the folate concentration was found to be low, the majority of these subjects did not have macrocytosis. Conclusions.—These data suggest that folate deficiency has become a rare event in the United States, and the utility of routine folate measurements for patients with anemia and/or increased mean corpuscular volume are difficult to justify.

Red blood cell folate concentrations in term newborns: recent findings in the Slovak Republic

Biologia ◽  
2014 ◽  
Vol 69 (12) ◽  
Author(s):  
Tatiana Reváková ◽  
Alena Vasilenková ◽  
Darina Behúlová ◽  
Margita Galliková ◽  
Ingrid Brucknerová
Keyword(s):  
Folic Acid ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Slovak Republic ◽  
The Body ◽  
Folate Concentration ◽  
Term Newborns ◽  
Multivitamin Supplements ◽  
Concentration Levels

AbstractFolate plays one of the most important functions for nucleotide biosynthesis and cellular methylation reactions in cells. Folate-mediated one-carbon metabolism is essential for metabolic processes in the human body. During periods of rapid cell growth, such as perinatal period, increased amounts of folate are required. The determination of red blood cell (RBC) folate concentration levels is the most accurate indicator of long-term folate level status in the body. This prospective study determined RBC folate concentration levels on the first day of life from umbilical cord blood samples in the whole group of full-term newborns (n = 150), who were hospitalized at the Department of Neonatology at the University Hospital in Bratislava. Immunochemical analysis for the determination of folate levels in erythrocytes was performed (Roche Diagnostics, Germany). Mothers were asked to select different types of food and use folic acid or other multivitamin supplements containing also folic acid. Our results of RBC folate ranged from 625 to 1748 ng/mL (5th–95th percentile). The median was 935 ng/mL and deficiency was not observed in any sample. RBC folate concentration levels in newborns due to mother’s intake of multivitamin supplements were significantly increased (p = 0.02). No differences were observed in the levels of RBC folate concentration when mothers used only folic acid. The RBC folate concentration tended to change based on many factors on both the mother’s and the newborn’s sides. Our results showed different results of RBC folate when focused on neonatal period and maternal intake of vitamins during pregnancy.

scholarly journals Effect of different dosage and administration schedules of folic acid on blood folate levels in a population of Honduran women of reproductive age

2008 ◽  
Vol 11 (8) ◽  
pp. 822-830 ◽  
Author(s):  
J Rosenthal ◽  
G Milla ◽  
A Flores ◽  
M Yon ◽  
C Pfeiffer ◽  
...  
Keyword(s):  
Folic Acid ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Folic Acid Supplementation ◽  
Conclusive Evidence ◽  
Reproductive Age ◽  
Serum Folate ◽  
Folate Supplementation ◽  
Double Blind ◽  
Supplementation Period

AbstractBackgroundObservational studies and clinical trials have shown conclusive evidence that periconceptional folic acid supplementation prevents up to 70 % of neural tube defects (NTD). The Honduran government wanted to implement a supplementation programme of folic acid but needed to assess the relative effects of two dosages of folic acid.ObjectiveTo determine the effect of two dosages of folic acid on blood folate levels in Honduran female factory workers aged 18 to 49 years.DesignThis was a randomized, double-blind control supplementation trial conducted in Choloma, Honduras. A total of 140 eligible women were randomly assigned to two dosage groups and followed up for 12 weeks. One group received a daily dosage of 1 mg folic acid and the other a once weekly dosage of 5 mg. Serum folate and red blood cell folate levels were determined by radioassay at baseline, 6 weeks and 12 weeks.ResultsSerum folate levels increased from 6·3 (se 0·2) to 14·9 (se 0·6) ng/ml (P < 0·0001) in women assigned to the 1 mg/d group and from 6·9 (se 0·3) to 10·1 (se 0·4) ng/ml (P < 0·0001) in those assigned to the 5 mg/week group. Red blood cell folate concentrations also increased significantly in both groups, albeit more slowly. Educational level, age and BMI were not associated with the changes in serum and red blood cell folate levels during the supplementation period. However, a differential effect on serum folate levels by dosage group and time was observed.ConclusionsAlthough both folate supplementation regimens increased serum and red blood cell folate levels significantly among the women studied, blood folate levels that are considered to be protective of NTD were reached faster with the daily dosage of 1 mg folic acid.

A Reassessment of the Red Blood Cell Folate Assay

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3209-3209 ◽  
Author(s):  
James Hoyer ◽  
Jennifer Oliveira ◽  
Nikola Baumann ◽  
Amy Saenger
Keyword(s):  
Folic Acid ◽  
Alcohol Abuse ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Previous History ◽  
Folate Deficiency ◽  
Folic Acid Supplementation ◽  
Serum Folate ◽  
Acid Supplementation ◽  
History Of

Abstract Abstract 3209 Background: The red blood cell folate (RCF) assay has historically been recommended as a more reliable indicator of tissue folate stores compared to the serum folate (SF) assay, as it is not affected by recent ingestion of food. However, the RCF assay suffers from inherent problems with imprecision and accuracy, which are not encountered with SF measurements. Furthermore, following the advent of required folic acid supplementation of many foods by the Food and Drug Administration (FDA) in 1992, folate deficiency is increasingly rare. Very few studies have looked at the value of the RCF versus the SF. We undertook a 10 year retrospective analysis of RCF and SF results to determine the clinical utility of RCF beyond that of SF. Methods: We retrieved all RCF and SF results from the laboratory information system at Mayo Clinic (Rochester, MN) ordered on inpatients and outpatients between 1999–2009. Data for patients who had concurrent orders for SF and RCF were analyzed and chart reviews were conducted on those patients with normal SF but low RCF. Abnormal values were defined by the National Health and Nutrition Examination Surveys (NHANES)/Center for Disease Control (CDC) criteria for folate deficiency (SF< 3.0 ng/ml, RCF < 140 ng/ml). Results: A total of 152,166 SF and 15,708 RCF were performed over the decade of the study. The prevalence of folate deficiency using only SF values was 0.39% and 0.27% using only RCF values. There were 1082 patients in which SFA and RCFA were ordered concurrently (Table 1). Only 1 patient (0.09%) had both abnormal SF and RCF. Chart reviews of the 4 patients with a normal SF but low RCF were as follows: 1) a 6 year old (yo). male with known folic acid transporter deficiency treated with Leucovorin. 2) a 58 yo male with history of gout, hypertension, psoriasis, and hyperlipidemia with normal hemoglobin (Hb) and MCV. 3) a 65 yo male with chronic diarrhea and suspected alcohol abuse; slight macrocytosis (MCV=100.3 fL) but normal Hb. 4) a 51 yo male with multifactorial gait disorder and alcohol abuse. There was a previous history of vitamin B12 deficiency but B12 levels were normal at this time. The CBC was notable for macrocytosis (MCV=115.1 fL) without anemia. Only in patient 4 did the RCF value result in the institution of folic acid supplementation. Conclusions: The RCF provides no additional information beyond that provided by the SF in virtually all situations. Thus SF alone is sufficient for assessment of folate stores. However, there is no evidence to support routine ordering of either SF or RCF, as true folate deficiency in the current era of FDA mandated folic acid supplementation is exceedingly rare. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Impact of asphyxia on red blood cell folate concentration levels in newborns

2015 ◽  
Vol 116 (07) ◽  
pp. 417-421
Author(s):  
T. Revakova ◽  
A. Vasilenkova ◽  
E. Ujhazy ◽  
M. Dubovicky ◽  
M. Mach ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Folate Concentration ◽  
Concentration Levels

scholarly journals Hematological and biochemical profile of person with macrocytic anemia in a tertiary health care centre of Nepal

2020 ◽  
Vol 10 (2) ◽  
pp. 1722-1727
Author(s):  
Rakesh Pathak ◽  
Sujata Pudasaini ◽  
Sushmita Ghimire ◽  
Anil Singh Basnyat ◽  
Anuj KC
Keyword(s):  
Folic Acid ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Peripheral Blood ◽  
Blood Smear ◽  
Hematological Parameters ◽  
Macrocytic Anemia ◽  
Peripheral Blood Smear ◽  
Blood Smear Examination ◽  
Red Blood Cell Indices

Background: Anemia is a nutritional problem worldwide with an increased risk of morbidity and mortality in all age groups. Macrocytic anemia often originates from abnormalities that impair the erythroid precursor maturation in the bone marrow. Since the clinical manifestations of different types of anemias are similar, hematological parameters including hemoglobin, Red blood cell indices, and Peripheral Blood Smear examination are useful in the diagnosis of anemia. Materials and Methods: This was a cross-sectional study done in the Department of Pathology at Nepal Medical College Teaching hospital. A total of 42 patients between 14 to 62 years with low Hb concentration according to the World Health Organization criteria for anemia were selected and a mean cell volume > 100 fL was taken for study. Peripheral blood smear examination, Red blood cell indices, Vitamin B12, and Folic acid level were evaluated. Results: There were 42 patients with macrocytic anemia enrolled in the study with a mean age of 31.85±12.49 years and with female preponderance. Hemoglobin level was slightly low in males compared to females. Red blood cell indices were slightly higher in males. The difference of serum Vit B12 and Folic acid in male and female was found to be significant. Conclusions: It was concluded that for the diagnosis of a specific type of anemia, hemoglobin, Red blood cell indices, reticulocytes percent, and PBS examination were important parameters. Serum Folic acid and Vitamin B12 level estimation along with other hematological parameters are important for the diagnosis of macrocytic anemia and its correlation

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