Check B12 first as never give alone for pernicious anaemia as can cause degeneration of
spinal cord or for undiagnosed megaloblastic anaemia
- Needed for growth and metabolism
- Pre pregnancy - reduces neural tube defects
- During 1st-trimester pregnancy - reduces neural tube defects
- Folate deficiency - dietary, malabsorption, high metabolic states
- Folate deficiency: Folate 5 mg PO OD for 4 months then recheck.
- Chronic haemolytic states
- Deficiency : Folate 5 mg od for 4 months. Up to 15 mg daily has been used for severe deficiency.
- Pregnancy: 5 mg daily, to be taken before conception and until week 12 of pregnancy.
- B12 and folate deficiency : give both
- Chronic haemolysis: Folic acid 5 mg daily (1-7 times per week)
- Never give with B12 deficiency without B12 replacement.
- Can lead to subacute combined degeneration of the cord.
- Undiagnosed B12 deficiency. Megaloblastic anaemia
- Subacute combined degeneration of cord if a low B12 not replaced at same time.
- Dyspepsia, Gastrointestinal disturbances