Fast Five Quiz: Vitamin B9 (Folate)

Emmanuel C. Besa, MD

Disclosures

November 07, 2022

Patients with folate deficiency may have glossitis and describe a sore tongue or pain upon swallowing. The tongue may appear swollen, beefy, red, or shiny, usually around the edges and tips initially. Angular stomatitis also may be observed. These oral lesions typically occur at the time when folate depletion is severe enough to cause megaloblastic anemia, although lesions may occur before the anemia.

Patients may present with gastrointestinal signs and symptoms, such as nausea, vomiting, abdominal pain, and diarrhea, especially after meals. Anorexia also is common and, in combination with the above symptoms, may lead to marked weight loss. However, be aware that an underlying malabsorption disorder could be causing these symptoms, as well as folate depletion. The lack of folate itself may not be the culprit.

Neuropsychiatric presentations include cognitive impairment, dementia, and depression. These manifestations overlap with those of vitamin B12 deficiency.

Brittle fingernails can be a sign of vitamin C deficiency or scurvy. Vitamin D deficiency is very common among women with polycystic ovary syndrome and is associated with many of its symptoms, including hirsutism. Vitamin B12 deficiency has been reportedly associated with night sweats, but vitamin B9 deficiency has not been associated with anhidrosis.

Learn more about folate deficiency.

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