Neurological Complications in Pernicious Anaemia Treated with Folic Acid

Unmetabolized folic acid prevalence is widespread in the older Irish population despite the lack of a mandatory fortification program

“…Untreated pernicious anemia can result in fatal neuropathy (5)(6)(7)(8)(9)(10)(11)(12). One milligram is now established as the tolerable upper intake level for daily folic acid intakes (13,14).…”

Interactions between plasma concentrations of folate and markers of vitamin B12status with cognitive performance in elderly people not exposed to folic acid fortification: the Hordaland Health Study

“…For instance, six decades ago, it was proposed that high folate status in vitamin B 12 -deficient subjects may deteriorate cognitive performance (5,6) . The adverse effect of high folate status may be confined to subjects with severe vitamin B 12 deficiency, leading to the methylfolate trap (61) .…”

“…Some earlier case reports have observed accelerated neurological deterioration in patients with pernicious anaemia and severe vitamin B 12 deficiency after treatment with folic acid (5,6) . These observations in combination with the known metabolic interrelation of folate and vitamin B 12 suggest that the effects of one of these B-vitamins on cognitive * Corresponding author: E. L. Doets, fax þ 31 317 483342, email doets@pallashrc.com…”

Effect of Vitamin B12 on Neuropathy in Pernicious Anaemia Treated with Folic Acid

“…of folic-acid treatment of pernicious anaemia pointed out by Israels and;Wilkinson (1949). The patient, who had had no previous neurological lesion, developed a severe neuropathy involving the brain, spinal cord, and peripheral nerves, in the* fifteenth month of folic-acid treatment, during which period her blood remained at a fair level.…”