Before we move on though,
I'd like to make sure that we’re
clear about folate deficiency.
Folate deficiency, most
With alcohol don’t forget
number of anemias, right?
You can have your megaloblastic anemia.
You can have a
We’ll talk about that in a second.
Also with alcoholics you may have sideroblastic
anemia which is a microcytic anemia.
I have mentioned that a few times.
Pregnant women, absolutely.
One of the major prenatal
And what if the mother
is deficient of folate
and the fetus becomes
deficient of folate?
Now we have NTD, right?
Neural tube defects such as spina bifida,
encephalocele and so forth.
Elderly once again, poor diet.
You’ll never know as to what happens.
Give me some drugs that
we talked about already?
I walked you through in great detail.
Now, we can just fly through it.
Give me the name of the
enzyme that it inhibits?
Dihydrofolate reductase, DHFR.
sure, such as celiac disease.
Okay, so big time.
If it’s B12, where are
you being reabsorbed?
Hence, maybe Crohn’s more so.
And if it’s jejunal, that will your folate,
And celiac disease can
affect you anywhere, huh?
Remember blunting of the villi?
Now just like we did at B12,
we’ll do this with folic.
In folic acid, do remember that
picture that I showed you where
you’re taking up the
you need to give up that methyl
and what do you need to --
Well, who accepts that B12?
Who accepts that methyl?
So green vegetable and meat products.
Polyglutamate converted to
monoglutamate by intestinal conjugases.
Know that, please.
Conjugases are big time important
when you’re dealing with folate.
So if for whatever reason, these
conjugases are not present,
your brush border enzymes, the conjugases.
Please understand that you’re not
able to properly absorb your folate
resulting in folate
The monoglutamate reabsorbed in jejunum.
So whenever you think
folate, think glutamate.
And anytime you reabsorb, you have to
be in the form of mono, mono, mono.
What does that mean?
For example, what’s the only type
of sugar “that you can take up”?
What’s the only type of
protein that you can take up?
This is monoglutamate.
Supply, big time different, three to
four months for folate in the liver.
How long for B12?
So that’s why it's very
important in a pregnant lady
to make sure she is properly being
supplemented with folate, folate, folate
amongst other things as well.