Folic acid and vitamin B12 are required for DNA synthesis.

Pathophysiology

  • Vitamin B12 is a coenzyme for 2 important enzymes responsible for the methylation of DNA, and production of succinyl-CoA.
    • Its absorption requires intrinsic factor produced by the parietal cells of the stomach.
    • In healthy individuals, stored vitamin B12 can last for up to 2 years before deficiency develops.
  • Folate is used for a variety of processes such as single‐carbon reactions, amino acid conversion, and synthesis of purines.
  • Folic acid/vitamin B12 deficiency leads to megaloblastic (macrocytic) anemia
    • Folic acid deficiency during pregnancy may lead to neural tube defects
    • Vitamin B12 deficiency can cause CNS disturbances
  • Folic acid analogs such as methotrexate

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