Folate Deficiency Treatment & Management

Updated: Nov 03, 2020
  • Author: Katherine Coffey-Vega, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Approach Considerations

The dosage of folic acid needed to prevent or reverse folic acid deficiency varies with the clinical circumstances, as follows [46] :

  • Folate-deficient megaloblastic anemia due to dietary insufficiency or antiepileptic drugs: 5 mg/day for 4 months
  • Malabsorption: Up to 15 mg/day for 4 months
  • Chronic hemolytic states and kidney dialysis: for prophylaxis, 5 mg daily to weekly, depending on the patient's diet and rate of hemolysis

Referral to a dietician may be indicated to ensure that the patient has appropriate dietary intake of folic acid. Fruits, vegetables, and fortified foods constitute the primary dietary source of folic acid. [2]  

Recommended intakes as published by the Food and Nutrition Board (FNB) at the Institute of Medicine (IOM) of the National Academies [18]  are as follows (RDA=recommended daily allowance, DFE=dietary folate equivalents, UL=tolerable upper level):

  • Adults and teenagers aged 14-19 years (male or female): RDA, 400 mcg DFE; UL, 1000 mcg DFE

  • Pregnant females: RDA, 600 mcg DFE; UL, 1000 mcg DFE

  • Lactating females: RDA, 500 mcg DFE; UL, 1000 mcg DFE

Because of variable absorption rates, an approximation of total folate intake in a day can be calculated as follows:

Grams of DFEs provided = grams of food folate + 1.7 × (grams of folic acid supplementation)