Folic acid is a water-soluble vitamin, or a vitamin which dissolves in water. Any amount that the cells do not use will be eliminated in your urine, so you need to constantly replenish your supply. The vitamin is vital for red blood cells, DNA, RNA, the brain and the nervous system. Thus, a folic acid deficiency can affect the development of the nervous system, but does not cause foot drop.
Folic Acid
Folic acid is the synthetic, manufactured form of folate or vitamin B9. It is essential for the proper development of the brain and the nervous system. Indeed, a folic acid deficiency in pregnant women has been associated with spina bifida and anencephaly. These are neural tube defects; in spina bifida, the membrane that lines the spinal cord or the membrane and part of the spinal cord stick out of the back. Part of the brain and some of the bones in the brain are missing in anencephaly. The cells use folic acid for metabolism and to make RNA, DNA, and red blood cells, as explained in "Williams Hematology" by Ralph Green, M.D., Ph.D., Professor of Pathology and Medicine at the University of California Medical Center.
Folic Acid Deficiency
According to the National Institutes of Health, dark green leafy vegetables, dried beans, fruits and peas are all good sources of folate. Since 1996, folic acid has been added to rice, corn meal, cereal, pasta, bread and flour. Their website lists the amount of folic acid contained in various foods. Even so, with all of the food sources available, a deficiency in folic acid is fairly common. This deficiency can be due to not eating enough vegetables and fruits, overcooking food, taking certain medications, having malabsorption diseases, kidney dialysis and alcoholism. A folic acid deficiency can cause confusion, diarrhea, inflammation in the tongue, depression and anemia; it does not cause foot drop.
Megaloblastic Anemia and Folic Acid Deficiency
If you have a folic acid deficiency, when the lab looks at a sample of your blood, they will see that you have what is referred to as a megaloblastic anemia. This is an anemia where the red blood cells are larger than they should be due to abnormalities in the production of DNA. Someone with a vitamin B12 deficiency will also have this type of anemia. This is why a physician will check the blood folic acid level and vitamin B12 level, as explained by Morey Blinder, M.D. of the Department of Medicine at Washington University School of Medicine in "The Washington Manual of Medical Therapeutics." A folic acid deficiency does not cause foot drop, but a vitamin B12 deficiency may.
Foot Drop and Vitamin B12 Deficiency
A vitamin B12 deficiency and a folic acid deficiency can both cause a megaloblastic anemia because the cells also use vitamin B12 to make DNA and they use this vitamin to break down folic acid to the form that the red blood cells need to mature. Unlike folic acid, however, a vitamin B12 deficiency can cause foot drop because this deficiency can cause neurological problems. Foot drop can be due to an anatomical, muscular or neurological problem. It is also called steppage gait because the foot will hang, the toes will point downward and the leg will have to be raised high while walking, as described in "Adams & Victor's Principles of Neurology" by Allan Ropper, M.D., Professor of Neurology at Harvard Medical School.
References
- "Adams & Victor's Principles of Neurology"; Allan Ropper, M.D., Martin Samuels, M.D.; 2009
- "Clinical Neurology"; Roger Simon, M.D., David Greenberg, M.D., Ph.D., Michael Aminoff, M.D.; 2009
- "Current Medical Diagnosis & Treatment 2011"; Stephen McPhee, M.D., Maxine Papadakis, M.D.; 2011
- National Institutes of Health: Folate
- "The Washington Manual of Medical Therapeutics"; Gopa Green, M.D., Ian Harris, M.D. et al.; 2004
- "Williams Hematology"; Marshall Lichtman, M.D., Thomas Kipps, M.D. et al.; 2010
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