Master Folate Deficiency with Picmonic for Medicine

With Picmonic, facts become pictures. We've taken what the science shows - image mnemonics work - but we've boosted the effectiveness by building and associating memorable characters, interesting audio stories, and built-in quizzing.

Folate Deficiency

Foliage Deficiency
Picmonic
Folate deficiency occurs due to malabsorption, insufficient dietary intake, impaired metabolism and increased requirements for folate. It results in a macrocytic, megaloblastic anemia similar to Vitamin B12 deficiency; however, unlike Vitamin B12 deficiency it does not result in neurologic symptoms.
12 KEY FACTS
CAUSES
Macrocytic Anemia
Macaroni Anemone

Macrocytic means “large cell” in Greek and macrocytic anemia refers to RBCs with an MCV>100. To form mature RBCs, RBC precursors divide multiple times, and they get smaller with each division. Without the proper building blocks for DNA, such as adequate levels of folate, the RBC precursors divide fewer times resulting in larger red blood cells.

Megaloblastic Anemia
Mega-blast Anemone

Megaloblastic anemia refers to anemia due to impaired DNA synthesis leading to changes in cell morphology. These changes include large RBCs (macrocytic) and large and hypersegmented neutrophils. Folate deficiency and vitamin B12 deficiency are the most common causes of megaloblastic anemia. In a patient with megaloblastic anemia, vitamin B12 deficiency must be ruled out prior to treating a patient with folate as folate supplementation in a patient with vitamin B12 deficiency can worsen neurologic symptoms.

CAUSED BY
Malabsorption
Intestinal-mallet

Folate is absorbed in the proximal jejunum and ileum. Damage in these areas, such as transmural inflammation due to Crohn’s Disease, can lead to malabsorption of folate and thus folate deficiency.

Dietary
Nutritional-plate

Inadequate intake of folate, which is primarily found in fresh green leafy vegetables and liver, can lead to folate deficiency. Folate is heat sensitive and thus is lacking in cooked foods.

Tea and Toast
Tea and Toast

The “tea and toast” diet is a diet seen in the elderly where they subsist on food with little nutritious value. This diet is devoid of foods containing folate, such as green leafy vegetables, thus leading to folate deficiency. Body stores of folate can be depleted in 4-5 months.

Alcoholics
Alcoholic-martini

Chronic alcoholics often have poor diets that can result in folate deficiency. Other reasons for folate deficiency in alcoholics include impaired enterohepatic cycling which can lead to malabsorption of folate. Alcoholics can deplete their body stores of folate in 5-10 weeks compared with nonalcoholics who’s stores take 4-5 months to be depleted

Medication-induced
Pill-bottle

There are many medications that can antagonize the effect of folate and thus lead to folate deficiency.

Methotrexate
Moth-T-Rex-ate

MTX is a folic acid analog that binds and inhibits dihydrofolate reductase, preventing the formation of the biologically active form of folic acid, tetrahydrofolate. This results in a functional folate deficiency as thymidine synthesis does not occur.

Trimethoprim
Tampon

TMP inhibits bacterial dihydrofolate reductase and has been found to exacerbate pre-existing folate deficiency.

Increased Requirement
Up-arrow Mouths

Conditions such as hemolytic anemia and pregnancy that demand a greater amount of folate can result in a relative folate deficiency (folate levels are actually within the normal range).

Hemolytic Anemia
Hemolysing-RBCs from Anemone

In hemolytic anemia the body attempts to compensate for RBC hemolysis by synthesizing new RBCs which require DNA synthesis. This results in a greater requirement for folate and thus a relative folate deficiency.

Pregnancy
Pregnant-woman

There is rapid cell division in pregnancy resulting in a greater requirement for folate and thus a relative folate deficiency.

Unlock all 12 facts & definitions with Picmonic Free!

JOIN FREE

Take the Folate Deficiency Quiz

Picmonic's rapid review multiple-choice quiz allows you to assess your knowledge.

START QUIZ NOW

It's worth every penny

Our Story Mnemonics Increase Mastery and Retention

Memorize facts with phonetic mnemonics

Unforgettable characters with concise but impactful videos (2-4 min each)

Ace Your Medical (MD/DO) Classes & Exams with Picmonic:

Over 900,000 students use Picmonic’s picture mnemonics to improve knowledge, retention, and exam performance.

Choose the #1 Medical (MD/DO) student study app.

Picmonic for Medicine (MD/DO) covers information that is relevant to your entire Medical (MD/DO) education. Whether you’re studying for your classes or getting ready to conquer the USMLE Step 1, USMLE Step 2 CK, COMLEX Level 1, or COMLEX Level 2, we’re here to help.

Works better than traditional Medical (MD/DO) flashcards.

Research shows that students who use Picmonic see a 331% improvement in memory retention and a 50% improvement in test scores.