FOLIC ACID AND SICKLE CELL ANAEMIA

Sickle Cell Anaemia as seen earlier adversely affects the production and the quality of red blood cells. The cells have a shorter lifespan. This leads to increased folic acid losses. Today we focus on this vitamin and its importance. Let’s begin, Shall we?

Folic acid, also called folate, is a B vitamin. It is referred to as Vitamin B9. The name is derived from the Latin name foliage meaning ‘leaf’. This is because folate is found in highest levels in green leafy vegetables. Folic acid can be artificially synthesized. It is used in food fortification and manufacture of supplements.

Folic acid plays a key role in certain body functions. Folic acid is critical for nucleotide synthesis. It is essential for protein utilization and red blood cell synthesis. Folic acid works well with other B vitamins especially vitamin B12. Now let us look into each of these roles and consequences of deficiency in more detail.

·         NUCLEOTIDE SYNTHESIS. Folic acid is required for the synthesis of purines and thymidine. These are important for DNA synthesis. DNA controls cell division in growth and development. Folic acid is crucial for pregnant women during the first four weeks. This ensures proper development of the brain and nerves from the neural tube that is formed by the 28^th day of pregnancy. Folate is needed on in life to maintain the integrity of body tissues and repair. Folic acid deficiency in pregnancy leads to neural tubal defects like spina bifida in newborns. It is of great importance that all women of childbearing age take adequate folate (additional 400mcg aside dietary folate) regardless of whether or not they intend to get pregnant.

·         PROTEIN UTILIZATION. Proteins are made of many smaller units called amino acids. Folic acid is needed for the metabolism of various amino acids including glycine, serine and methionine. Folic acid, together with Vitamins B6 and B12 are important in methionine metabolism. Folate and B12 convert homocysteine to methionine while B6 converts homocysteine to cysteine. High levels of homocysteine are associated with vascular disease. The role of folic acid is cemented in the regulation of these diseases through homocysteine regulation.

·         RED BLOOD SYNTHESIS. As we saw earlier, folic acid is important for DNA synthesis. DNA controls the production of red blood cells. In sickle cell anaemia because the red blood cells are short-lived, the levels of folate in the body are often low. As a result, DNA synthesis is impaired and the red blood cells fail to divide well. They remain as large immature precursors of the red blood cells. This condition is referred to as megaloblastic anaemia. These cells have little haemoglobin. They cannot package and transport oxygen sufficiently. Because of the anaemia, one may be anxious, lack energy, have a poor appetite, stomach pains, and cracked lips. You may also suffer from depression. This deficiency severs the sickle cell condition because the red blood cell levels are already too low and crescent shaped cells are predominant.

We need to have a daily balanced diet to be provided with adequate folic acid. This is to prevent folate deficiency. Green leafy vegetables are highly recommended. Some good sources are spinach, cauliflower and sprouts. Whole grains, lentils and pinto beans can be included in the diet. Red meats like beef liver are rich in folic acid but should be eaten in minimal amounts. The red meats are rich in saturated fats hat are bad for our health. This is because they contribute to development of vascular disease. Folic acid is heat sensitive therefore we are advised to eat fresh, uncooked vegetables and fruits. Avocado, beets, sesame nuts (simsim) and cashew nuts are good sources of such. Enriched cereals are also encouraged.

While a balanced diet provides enough folic acid, your doctor or nutritionist may recommend that you take daily folic acid supplements.

This is to cover the losses due to red blood cell death as well as slow metabolism by the body. The supplement tablets should provide between 400-1000 micrograms of folic acid daily. Majority of  patients have a high-dose folic acid  prescription of 1000mcg(1mg) daily. In some cases a B-complex supplement may be given. This particularly true when one has vitamin B12 deficiency, pernicious anaemia.*Folic acid can clear the blood signs of B12 deficiency and hide the neurological signs masking the deficiency. Vitamin B12 is needed for growth and maintenance of the insulating myelin sheath around nerve fibres. Only a skilled professional can diagnose the nutrient deficiency. Self-diagnosis and advice from unskilled self-proclaimed experts are not advised. Well, that’s folic acid for you. Remember to take you greens, drink your water and exercise to stay in tip-top shape.

*The exact doses of folic acid taken by patients that hide B12 deficiency are still subject to research.

Love Life!!
Joyner