•Address the Cause(s)
poor diet,
alcohol XS, malabsorption, elderly, blood disorders
•
•Dietary Advice
healthy
eating – green leafy vegetables, potatoes, oranges
fortified foods – some
breakfast cereals
•
•Supplement with appropriate amounts of
nutrient
Folic acid 5
mg x 1-3/day for proven deficiency; x1/wk if MTX
Pregnancy 400 ug/day but
high NTD risk 5 mg/day (see BNF)
Caution if cancer – may
promote tumor growth ask oncologist
•
•Consider need for other nutrients
Other
deficiencies - vitamin B if alcohol, zinc if malabsorption
poor diet in
pregnancy consider prenatal multivit/multimineral
•
•Once main deficiency corrected
Retest rbc
folate (better than serum folate) after 2-3 months
High daily
folic acid may reduce zinc absorption long-term
Consider long-term
400ug/day or 5mg/wk if status is poor