haematinics

Folic Acid: Folic acid is inactive compound. Body converts folic acid into tetrahydrofolic acid, an active compound.  Folic acid is administered orally. It  is absorbed from duodenum and jejunum. It is water soluble vitamin excreted through kidney. It does not produce any side effects

 Folic deficiency may be due to any one of following reasons:

• Chronic Alcoholism
• Dietary deficiency of folic acid
• Increase in folic acid demand like during pregnancy, lactation
• Intestinal disease causing poor folic acid absorption
• Drugs that inhibit dihydro folate reductase. This enzyme converts folic acid to tetra hydro folate

Folic acid deficiency causes megaloblastic anaemia.

Cyanobalamin (Vitamin B12): Large intestine has cyanocobalamine. It is synthesised by microorganism and it is not absorbed. Human body depends upon exogenous source of cyanocobalamine. It is obtained from non vegetarian food. Vegitarian diet does not contain cyanocobalamine. 

Body needs cyanocobalamine for normal DNA synthesis. Its deficiency causes megaloblastic anemia. Dediciency occurs due to poor absorption or low dietary cyanocobalamine. Intrinsic factors and vitamin receptors for absorption are responsible for cyanocobalamine absorption. Deficiency of any one causes poor absorption of cyanocobalamine. 

cyanocobalamine can be administered oral, IM or SC route. Folic acid alone can produce haematonic effects. It mask utility of cyanocobalamine. But it will produce serious neurological problem Thus folic acid should always be administered along with cyanocobalamine.  In pernecious anemia. folic acid and cyanocobalamine should be administered through out life. There is no reported side effcts of cyanocobalamine.

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