Folic Acid & Chemotherapy

Folic acid
Folic acid pills. (Image: BWFolsom/iStock/Getty Images)

Folic acid, also called folate and vitamin B9, is a vitamin essential to red blood cell production. Many people receiving chemotherapy for cancer experience drops in their folic acid levels and blood counts due to the effect of certain drugs. A low red blood cell count indicates anemia, a condition of reduced oxygen distribution throughout the body from the lower circulation of blood cells. Anemia can be caused by deficiencies in folic acid, several other B vitamins, iron and even protein.

Blood Composition Diagnosis

Because anemia may produce no symptoms, your blood count will be periodically monitored during your chemotherapy regimen. Depending on which drugs and supplements you are taking, folic acid-deficiency anemia may not be anticipated by your health care team. If you have symptoms of anemia, including fatigue, weakness, dizziness and shortness of breath, tell your doctor. It’s important to pinpoint the cause of anemia in order to avoid permanent nerve damage brought on by vitamin B12 deficiency, which high folic acid supplementation can hide. Besides diagnosing the nutrient deficiency, your doctor may need to order a blood transfusion if your red blood cell count is dangerously low.

Medication-Related Causes

A common cause of folic acid insufficiency is the drug methotrexate, a substance used to kill rapidly dividing cancer cells. This medication suppresses folic acid’s natural function in supporting normal rapid cell division in the body, such as in blood cell production and fetal development. If you are taking methotrexate, your doctor may also prescribe leucovorin, a reduced form of folic acid that shields the normal metabolic use of vitamin B9 by cells.

Folic Acid Management

Whether or not you are taking methotrexate, your health care team may instruct you to follow your normal diet. This should include sources of folic acid in every food group. Yogurt, liver, eggs, black-eyed peas, enriched grains, broccoli, asparagus, spinach, cantaloupe and bananas are good foods to eat for folic acid and other B vitamin. Take your leucovorin on a regular schedule as directed. Do not add folic acid supplements without medical authorization, especially if you are on methotrexate.

Anemia Management

Chemotherapy can affect your appetite and prompt dietary imbalances. These eating patterns may become habitual even after your treatment regimen has ended. On your doctor’s advice, take steps to avoid vitamin-deficiency anemia over the long-term by eating a healthy diet. Some brands of fortified cereal provide 100 percent of daily folic acid needs, which can help you prevent the return of anemia symptoms.

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