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Folic Acid

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Defective Hemoglobins. Sickling Disease (Sickle Cell Anemia) Thalessemias ... Inability to make adequate amount of hemoglobin leading to small sized erythrocytes ... – PowerPoint PPT presentation

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Title: Folic Acid


1
Folic Acid
  • I am not responsible for errors
  • Nosaj

2
  • This is a deficiency of normal sized erythrocytes

3
  • Normocytic
  • Deficiency of normal sized erythrocytes
  • Iron Deficiency
  • Hemorrhage
  • Hemolysis
  • Anemia of chronic disease (autoimmune disease,
    cancer etc.

4
  • This is a deficiency of hemoglobin leading to
    small sized erythrocytes.

5
  • Microcytic
  • Causes include Iron deficiency

6
  • This is a condition where the erythrocytes are
    larger than normal.

7
  • Megaloblastic
  • Causes
  • Folic acid
  • Cobalamin (cyanocobalamin)

8
  • This is a decreased ability of the bone marrow to
    make new erythrocytes.

9
  • Aplastic Anemia

10
  • Defective Hemoglobins

11
  • Sickling Disease (Sickle Cell Anemia)
  • Thalessemias

12
  • Folic acid was discovered by who?

13
  • Professor Snell (U of Texas)
  • Dr. Snell ate a lot of spinach and now his farts
    smell really bad. Spinach because folic acid was
    named after folium or leaf from spinach.

14
  • What is the recommended dose of Folic acid for
    women contemplating pregnancy?

15
  • 0.4mg (400 µg) to 1 mg (1,000 µg)
  • Why are women recommended to take this vitamin?

16
  • Women are recommened to take this vitamin to
    prevent neural tube defects (NTDs) such as spina
    bifida and anencephaly.

17
  • The commercial form of folic acid is comprised of
    what?

18
  • Pteridine ring
  • p-aminobenzoate
  • glutamate

19
  • Dietary polyglutamates are cleaved to the
    monoglutamate vitamin by a

20
  • ?-L-glutamylcarboxy peptidase commonly called
  • conjugase

21
  • Folic acid and tetrahydrofolate are absorbed as
    the _________ form

22
  • Monoglutamate

23
  • What does methotrexate do?

24
  • Methotrexate inhibits the conversion of Folic
    acid to tetrahydrofolate (THF, FH4)

25
  • How many forms of folic acid are cofactors?

26
  • Four forms.

27
  • 5,10-methylene THF (N5,N10-methylene THF)
  • What does this form of the cofactor do?

28
  • N5,N10-methylene THF
  • Methylation of dUMP forming dTMP
  • Synthesis of serine from glycine.
  • I bet the some guy in a lab named this dump after
    taking a shit.

29
  • What does the 10-formyl THF form of folic acid do?

30
  • 10-formyl THF
  • Conversion aminoimidazole carboxamide fibotide
    (AICAR) to Formamidoimidazole carbxamide ribotide
    (FAICAR) in purine biosynthesis.

31
  • 5,10 methenyl THF

32
  • Synthesis of formylglycine ribotide (FGAR) from
    glycine amide ribotide (GAR) in purine
    biosynthesis.

33
  • 5 methyl THF (N5-methyl THF)

34
  • Methylation of homocysteine forming methionine
  • Important
  • This is the one cofactor form which is not
    interchangeable with any of the other cofactor
    structures.
  • It is the predominant

35
  • This cofactor of folic acid undergoes methylation
    of homocysteine forming methionine.

36
  • 5 methyl THF (N5-methyl THF)
  • Methylation of homocysteine forming methionine.
  • This is the one cofactor form which is not
    interchangeable with any of the other cofactor
    structures.

37
  • This is the administered form of folic acid
    following methotrexate therapy to return
    tetrahydrofolate activity to normal levels in
    benign tissues.

38
  • 5-Formyl THF (Folinic acid, citrovorum factor)

39
  • What is the leading cause of folic acid
    deficiency in the United States

40
  • Alcoholism

41
  • True or False
  • Sunlight can destroy ultraviolet light (sunlight)
    destroys body stores of folate.

42
  • Possible
  • Based on correlation that more problems are seen
    with fair skinned individuals living in sunny
    areas.

43
  • What is the order of cofactors starting with THF
    and ending With THF

44
  • THF
  • N10 formyl THF
  • N5,N10 Methenyl THF
  • N5,N10 Methylene - THF
  • N5 Methyl- THF
  • THF

45
  • Its a good question because it is heat labile
    and is destroyed in the cooking process.

46
  • What are the commercial forms of folic acid

47
  • Folic acid
  • Sodium Folate
  • Leucovorin Calcium (5 formyl THF, folinic acid,
    citrovorum factor)

48
  • True or False
  • Folic acid has an RDA.

49
  • True
  • RDA
  • Dietary Folate Equivalent (DFE)

50
  • What is the RDA for Folic Acid?

51
  • RDA
  • Adults 400 mcg DFE/DAY
  • Pregnancy 600 mcg DFE/DAY

52
  • What type of anemia would a woman have during
    menstruation?

53
B
  • Normocytic because it can be a deficiency of
    iron, hemorrhage.

54
  • Dr. Block has an iron deficiency what type of
    anemia would it be?

55
  • Microcytic
  • Inability to make adequate amount of hemoglobin
    leading to small sized erythrocytes
  • Iron deficiency (He said he has problems with
    iron absorption)

56
  • This anemia is caused by toxins.

57
  • Aplastic anemia

58
  • What form of folic acid stored in the body? 3-6
    month supply?

59
  • Polyglutamate form

60
B12
  • What is the other name for B12?

61
  • Cyanocobalamin

62
  • What happens in the stomach of cobalamin uptake?

63
  • The cobalamins combine with a stomach protein
    called R -Factor
  • R B12 --gt R---B12

64
  • True or False
  • Deficiency of B12 is a direct result of poor diet.

65
  • False
  • Why
  • BC The problem is due to malabsorption due to
    lack intrinsic factor.

66
  • True or False
  • Your liver stores only 2 month supply of B12.

67
  • False
  • Due to enterohepatic cycling you could
    potentially get 20 years.

68
  • What are the two biochemical functions of B12.

69
  • Regenerate methionine by transfering the methyl
    group from 5-CH3-THF to homocysteine.
  • The final reaction in the conversion of propionyl
    CoA to succinyl CoA.
  • (Key RXN causes damage to mylen sheath.

70
  • What are symptoms of a cobalamin deficiency?

71
  • A characteristic megaloblastic anemia which may
    be masked by a megaloblastic anemia by folic acid
    deficiency.
  • Degeneration of the myelin sheath in the spinal
    chord
  • Degeneration of the peripheral nerves affecting
    the reflexes and walking
  • Deterioration of the patients mental state.

72
  • If you were deficient in both cyanocobalamin and
    folic acid would you still have megablastic
    anemia?

73
  • Because you wouldnt be able to get out of the
    5-methyl THF trap

74
  • What was that again?

75
  • Megablastic anemia
  • Degeneration spinal chord
  • Degeneration of peripheral nerves
  • Trouble walking
  • ?Mental state

76
  • Loss of intrinsic factor may be a result of what
    process?

77
  • Achlorohydria
  • ??gastric acid production
  • W/O HCl

78
  • If a deficiency of B12 is apparent what would be
    high in the blood?

79
  • Homocysteine
  • 5-CH3-THF (5 Methyl THF) (from the methyl trap
    hypothesis.)
  • Methylmalonyl CoA

80
  • For some reason I have lost the ability to
    produce intrinsic factor how long do I have in
    liver supplies?

81
  • 3 - 6 year supply of the vitamin in the liver.
  • Some sources say that if the liver stores are
    excellent, the patient may get along for the next
    twenty years due to efficient enterohepatic
    cycling.

82
  • Cobalamin is a cofactor for what conversion step
    in the Kreb Cycle?

83
  • Methylmalonyl CoA to succinyl CoA

84
  • How do we make B12?

85
  • This is the one, true natural vitamin.
  • It is obtained from anaerobic bacteria.
    (Fermentation- not in the body)

86
  • What is the RDA for B12?

87
  • 2.4 µg/day

88
  • What is the UL of B12

89
  • None Reported.

90
  • What are food sources of B12?

91
  • Liver
  • Kidney
  • Red Meat
  • Dairy products
  • Clams and mussels high concentrations.

92
  • What drugs do you not want to take with B12?

93
  • H2RAs
  • PPI

94
  • What drug decreases absorption of folic acid?

95
  • Phenytoin Dilantin

96
  • What are the dietary and natural forms of
    cobalamin

97
  • Commercial Form R CN
  • Dietary forms R CH3 adenosyl
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