Folate is a water soluble vitamin whereas folic acid is the synthetic form of folate that is found in supplements and added to fortified foods.[4]. Folate, also known as folic acid or vitamin B9 is a vitamin that people with Crohn's Disease (especially those with Ileocolitis and Ileitis) are commonly deficient in. If you are found to be deficient in folate, recent studies have found that supplementation with folate, vitamin B6, and vitamin B12 rather than just folate has superior results.[2] And the University of Maryland Medical Center recommends taking ALL B Complex vitamins rather than just one at a time to avoid imbalances.


Symptoms of Vitamin B9 / Folate Deficiency:

Deficiency results in a macrocytic anemia, megaloblastic anemia as folate deficiency can hinder the production of red blood cells, it increases the risk of anemia.[1]. With folate deficiency, your body may make large red blood cells that do not contain adequate hemoglobin.[4] Folate deficiency can also lead to elevated levels of homocysteine in the blood. Other signs of folate deficiency are often subtle. Digestive disorders such as diarrhea, loss of appetite, and weight loss can occur, as can weakness, sore tongue, headaches, heart palpitations, irritability, forgetfulness, and behavioral disorders.[4]

Anatomy of Absorption:

As folate is primarily absorbed in the jejunum extensive inflammation in the jejunum (middle portion of the small intestine) or removal of the jejunum increases the likelihood of fotate deficiency.[3]

Drug Interactions

Drugs shown to interfere with Folic Acid Utilization include methotrexate and sulfasalazine. If sulfasalazine is prescribed, folic acid supplements are normally given. The purpose of methotrexate is to inhibit dihydrofolate reductase and thereby reduce the rate de novo purine and pyrimidine synthesis and cell division. Low dose methotrexate is used to treat inflammatory bowel disease. Low doses of methotrexate can deplete folate stores and cause side effects that are similar to folate deficiency. Both high folate diets and supplemental folic acid may help reduce the toxic side effects of low dose methotrexate without decreasing its effectiveness.[4]

Natural Sources of Vitamin B9:

For More Information on Folate Deficiency


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