American Journal of Clinical Nutrition, Vol 13, 369-377, Copyright © 1963 by The American Society for Clinical Nutrition, Inc.

The Effect of Small Doses of Folic Acid in Nutritional Megaloblastic Anemia

¹ From the Department of Internal Medicine B, Hadassah University Hospital and the Department of Bacteriology, Hebrew University-Hadassah Medical School, Jerusalem, Israel, and the Department of Medicine, Rangoon General Hospital, Rangoon, Burma

The results of therapeutic trials in fifty-six patients with severe nutritional megaloblastic anemia due to folate deficiency with varying parenteral doses of pteroylglutamic acid and leucovorin are described.

The hematologic response was good in all patients given 1,000, 500 and 100 µg. pteroylglutamic acid per day parenterally for fourteen to twenty-one days, as well as in patients given 200 µg. leucovorin parenterally or 5,000 µg. pteroylglutamic acid orally per day for the same length of time. No appreciable therapeutic response was elicited in patients given 10 µg. pteroylglutamic acid per day parenterally.

After treatment the whole blood folate determinations disclosed subnormal values in all patients treated parenterally, but normal activity was found in the blood samples of patients treated orally with 5 mg. pteroylglutamic acid per day. These results indicate that 1,000 µg. or less of pteroylglutamic acid given daily to patients with severe folate deficiency is enough to induce hematologic remission but is probably insufficient to replenish the depleted stores of this vitamin.