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A serum folate of 3 μg/L or lower indicates deficiency. [98] Serum folate level reflects folate status, but erythrocyte folate level better reflects tissue stores after intake. An erythrocyte folate level of 140 μg/L or lower indicates inadequate folate status. Serum folate reacts more rapidly to folate intake than erythrocyte folate. [113]
A serum folate level of less than 7 nmol/L (3 μg/L) is indicative of folate deficiency; Red blood cell folate testing is not routinely performed, since serum folate is sufficient in most cases, however, if there is a strong suspicion of folate deficiency despite a normal serum folate level, a red cell folate test may be performed.
The un-methylated form, folic acid (vitamin B 9), is a synthetic form of folate, and must undergo enzymatic reduction by dihydrofolate reductase to become biologically active. [1] It is synthesized in the absorptive cells of the small intestine from polyglutamylated dietary folate. It is a methylated derivative of tetrahydrofolate.
The proton-coupled folate transporter is a protein that in humans is encoded by the SLC46A1 gene. [5] [6] [7] The major physiological roles of PCFTs are in mediating the intestinal absorption of folate (Vitamin B9), and its delivery to the central nervous system.
10-CHO-THF is produced from methylenetetrahydrofolate (CH 2 H 4 F) via a two step process. The first step generates 5,10-methenyltetrahydrofolate: [2]. CH 2 H 4 F + NAD + CH 2 H 2 F + NADH + H +
This requires active folate and vitamin B 12, in order to donate a methyl group. Active folate is known as 5-methyltetrahydrofolate (5-MTHF). Another pathway for the conversion of homocysteine back to methionine also exists, involving methylation with trimethylglycine (also called betaine or abbreviated to TMG) as a methyl donor.
Diet improvement is a way to combat nutritional anemia and this can be done by taking dietary supplements such as iron, folate, and Vitamin B12.[2] These supplements are available over-the-counter however, a doctor may prescribe prescription medicine as needed, depending on the patient's health needs.
Dihydrofolic acid (conjugate base dihydrofolate) (DHF) is a folic acid (vitamin B 9) derivative which is converted to tetrahydrofolic acid by dihydrofolate reductase. [1] Since tetrahydrofolate is needed to make both purines and pyrimidines, which are building blocks of DNA and RNA, dihydrofolate reductase is targeted by various drugs to prevent nucleic acid synthesis.
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