SHM's Clinical Quick Talks-One-Minute Guide to Folate Testing in Anemia

One-Minute Guide to Folate Testing in Anemia

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Folate deficiency is not a common cause of anemia in hospitalized patients. Since the American diet has been fortified with folic acid, the prevalence of folate deficiency has significantly decreased. Two studies found that out of tens of thousands of inpatient RBC and serum folate level tests, only a small number of individuals were found to have deficient levels. Furthermore, one of the low levels identified was determined to be spurious. The cost of folate testing ranged from $32,000 to $316,000, with a high cost per deficient result. Folate deficiency is extremely rare in North American patients, except in cases of severe alcohol use disorder, malabsorption, and severe malnutrition. If there is a high suspicion of folate deficiency, patients can be empirically treated or encouraged to eat foods rich in folate. It is important to also rule out a deficiency in vitamin B12.

Keywords

folate deficiency

anemia

hospitalized patients

American diet

folic acid

prevalence

RBC

deficient levels

cost of folate testing

vitamin B12 deficiency