Folic acid deficiency determination

Folic add (plasma) 3.1-12.4 ng/mL or mcg/L (7-28 nmol/L) Used to determine folic acid deficiency. 

Nearly all microbiologic assays for folic acid activity have used Streptococcus faecalis and Lactobacillus casei. Earlier it appeared that these organisms could not detect folic acid deficiency in man (C2, L8) for example, in one study using S. faecalis there was no detectable activity in the fasting serum of humans (C3). Administration of a loading dose of folic acid with subsequent assay by S. faecalis (G9) has served as a workable means of determining folic acid deficiency (C6), a technique having definite drawbacks (G10). 

B12 from those due to folic acid deficiency. In all cases the folic acid determinations agreed with the clinical findings more detailed results are given elsewhere (B12). 

For correlation with the serum folic acid, FIGlu determinations were carried out using two methods (L9, S6). Both proved insensitive, notably where no urinary FIGlu was excreted despite clinical proof of PGA deficiency. 

K7. Kohn, J., Mollin, D. L., and Rosenbach, L. M., Conventional voltage electrophoresis for formiminoglutamic acid determination and folic acid deficiency. /. Clin. Pathol. 14, 345-350 (1961). 

Once a diagnosis of megaloblastic anemia is made, it must be determined whether vitamin B12 or folic acid deficiency is the cause. (Other causes of megaloblastic anemia are very rare.) This can usually be accomplished by measuring serum levels of the vitamins. The Schilling test, which measures absorption and urinary excretion of radioactively labeled vitamin B12, can be used to further define the mechanism of vitamin Bi2 malabsorption when this is found to be the cause of the megaloblastic anemia. 

The resnlts of folic acid measnrements may vary depending on the assay method nsed. Decreased serum folic acid levels indicate a folate deficiency megaloblastic anemia that may coexist with a vitamin B12 deficiency anemia. An erythrocyte folic acid level is less volatile than sernm levels, as it is slow to decrease in an acnte process such as drug-induced folic acid deficiency, and slow to increase with oral folic acid replacement. However, the clinical ntflity of determining the erythrocyte folic acid level is qnestionable, and the procedure should be reserved for cases in which the clinician snspects folic acid depletion and the serum folic acid may be falsely elevated or depleted. 

The male client at the outpatient client was diagnosed with folic acid deficiency anemia and was given a sample of oral folic acid. At the follow-up visit the nurse assesses the client to determine effectiveness of the treatment. ich data indicates the treatment is effective ... 

An improperly balanced diet may cause mutations and chromosomal aberrations. For the development of methods to counteract such changes, it is vital to determine the possible correlations between the dietary components and DNA changes. Folic acid and vitamin B12 are crucial elements in the methy-lation of DNA, proteins and neurotransmitiers. The development of neural tube defects associated with folic acid deficiency is related to methylation dysfunction and a malfunctioning expression of the genes responsible for the tube formation. Furthermore, it is believed that DNA hypermethylation causes mutations related to tumor initiation or development. Previous observations have shown that diets supplemented with the B group vitamins for 15 years were correlated with a significant reduction in the development of tumour diseases (Fenech 2001). 

We investigated the biosynthesis of component amino acids of glutathione (GSH) in vitamin-Bi2 or folic-acid deficient rats (1). Glycine-2-C or L-cystine-S was administered intraperitoneally to normal or the deficient rats. Liver GSH was determined, then isolated, and the radioactivity of GSH and its component amino acids was determined. The extent of incorporation of either glycine-2-C or cysteine-S into the respective moieties of GSH was not appreciably affected by either deficiency, indicating that neither vitamin is involved in the sjrstems which catalyze the synthesis of GSH from glycine, cysteine, and glutamic acid, a conclusion which is in accord with those of Bloch (2) and Snoke and Rothman... 

Table I summarizes the effects of the various deficiencies of the vitamin B complex upon the response to a variety of antigenic stimuli in different test animals. It is the reviewers opinion that, with the exception of the criticisms already made, this table represents the results of well-controlled, adequate experiments. It is quite apparent that the individual members of the vitamin B complex play a very important role in determining antibody response. Their absence may produce a marked impairment in antibody production. Generalizations on this subject are dangerous, but it would appear that pyridoxine, pantothenic acid, and folic acid deficiencies show the most consistent deleterious effects upon antibody production. It is also apparent that the effects of the individual deficiencies may vary widely depending upon the antigen employed.

The underlying cause of anemia (e.g., blood loss iron, folic acid, or B12 deficiency or chronic disease) must be determined and used to guide therapy. 

The underlying cause of anemia (e.g., blood loss iron, folic acid, or vitamin B12 deficiency or chronic disease) must be determined and used to guide therapy. As discussed previously, patients should be evaluated initially based on laboratory parameters to determine the etiology of the anemia (see Fig. 63-3). Subsequently, the appropriate pharmacologic treatment should be initiated based on the cause of anemia. 

The L. casei method described here can also be used to determine absorption of folic acid. Five milligrams of folic acid is given by mouth samples are obtained at 0, 2, 4, 6, and 8 hours. In cases of deficient folic acid absorption, normal peak levels are not obtained in the malabsorption syndrome, a flat curve indicates no absorption. Normal peak levels are maintained during 2-4 hour intervals (B3). 

C. The only effective treatment of pernicious anemia is supplementation of vitamin B12.It is important to determine whether megaloblastic anemia is from a deficiency of folic acid or vitamin B12. Treatment of vitamin Bi2-deficient anemia with folic acid may result in neurological damage if vitamin Bi2 is not adequately supplemented. 

Studies on growth factors required by certain microorganisms, for example Streptococcus faecalis and Lactobacillus casei, and of their relevance in animal nutrition, led to the isolation and characterization of folic acid, pteroylglutamic acid (104), the structure of which was determined in 1946. It is an essential vitamin for man and together with vitamin B12 it is involved in the development of blood cells. Deficiency causes macrocytic anaemia. Many microorganisms do not use exogenous folic acid, but synthesize their own, and some... 

Deficiencies of folic acid and vitamin B1 are relatively common. Whenever macrocytic anemia is present, evaluation of these two vitamins is necessary 10 determine the cause of the condition, The standard method of measuring folic acid has been the microbiological assay (Bailey et al.. 19821. which can be used to measure folic acid in serum, blood, tissues, and foods. Improved high performance liquid chromatography (HPLC) methods have... 

Folic Acid (folate). Chemically, folic acid is a pteryl-glutamic acid. The several forms that occur in nature depend on the numbers of glutamic acid units and methyl groups in the molecules. Because of its usual low concentration, folic acid is generally determined in food materials by the microbiological assay with lactobacillus casei and measured turbidimetrically or titrimetrically. Deficiency of this vitamin could result in... 

Treatment of the folate-deficient patient with folic acid permits the early eryth-roblast to divide, producing late erythroblasts and, eventually, reticulocytes and red blood cells. These effects can very easily be detected by examining blood samples taken before and after the injection and determining the percentage of reticulocytes. Normally, the concentration of reticulocytes in the bloodstream is quite low. A burst in the nrunber can be induced by injecting folic acid (0.1 mg) into a folate-deficient patient. It should be pointed out that injecting vitamin B 2 into a Bi2-deficient patient, or folate into some Bi2-deficient patients, can also cause this burst. Thus, the hematological response to vitamin injections is not a reliable indicator of which vitamin deficiency was present. 

Mental dysfunction in folate-deficient elderly people has been reported, but it is not easy to determine cause and effect. Folic acid has been found to correct the dementia in some patients (M18, S37). Sneath (S38) found no correlation between mental assessment score and serum or erythrocyte folate activity. However, they did find a correlation between mental assessment scores and erythrocyte folate in those patients who had low erythrocyte folate values. 

In this sense, it has also to be considered on one hand that high doses of folic acid may mask the megaloblastic anaemia due to vitamin B12 deficiency seen in elderly people as a result of atrophic gastritis. On the other hand, we have to be aware that vitamin Bg status is primarily a determinant of postprandial Hey levels, but not fasting levels. Thus, in studies of B vitamin supplements and Hey, it often appears that vitamin Bg has little effect on Hey levels because these studies typically only look at fasting Hey levels. 

The possible functions of pantothenic acid, pyridoxine, or folic acid in the mechanisms involved in the release of antibody from their sites of formation were further investigated as follows (Ludovici et al., 1951b). Rats were immunized with human erythrocytes while on the deficient diets and their initial titers determined. Four days later the animals were injected intraperitoneally with the respective vitamin and maintained on an adequate control diet for the remainder of the experiment. Antibody titers were determined periodically thereafter. The effect of the... 

---