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SUMMARYPrevalence of anemia and deficiencies of iron, folic acid and vitamin B12 in an Indigenous community from the Venezuelan Amazon with a high incidence of malariaThe objective of this work was to determine the prevalence of anemia and deficiencies of iron, folic acid and vitamin B12 in Betania del Topocho, a Piaroa community from Estado Amazonas, Venezuela, a zone with a high incidence of malaria. INTRODUCTIONAnemia and iron deficiency constitute the most frequent nutritional problems worldwide. Mean hemoglobin, ferritin and folic acid concentrations by age and gender in the Piaroa community of Betania del Topocho, Amazonas State, Venezuela The prevalence of anemia and deficiencies of iron, folic acid and vitamin B12 by age and gender is shown in Table 3. Prevalence of anemia and deficiencies of iron, folic acid and vitamin B12 in the Piaroa community of Betania del Topocho, Amazonas State, Venezuela. Vitamin B12 deficiency: DISCUSSIONThe study performed in this community showed a high prevalence of anemia and folic acid deficiency, that is evident not only by individual data but also by the mean levels obtained for the entire population. Anemia is the condition in which there are not enough healthy red blood cells (RBCs) to carry oxygen to the tissues in the body. Folate (vitamin B9) deficiency anemia: This vitamin also prevents neural tube defects during pregnancy. You must keep in mind that though anemia may be common in the United States, it does not make it any less dangerous for the health of your baby or yourself. Distribution by gender Population studied was classified by age and gender, showing that all groups presented borderline or deficiency values for hemoglobin, ferritin and folic acid.Children in general, especially infants less than 3 years old, presented the lowest levels for hemoglobin and ferritin regardless of gender (Table 2).
These low general mean values, indicate that the majority of the population studied is affected by these deficiencies, which requires an immediate and massive nutritional intervention.The sample studied included individuals from all age groups, and although the individuals voluntarily included themselves in the study, they represented almost 50% of the community and had the same age distribution found for the indigenous community of the whole Amazonas State. There are some severe side effects associated with anemia that may mirror another disorder, i.e.
Analysis performed included hematology by coulter counter, ferritin quantification by ELISA with monoclonal antibodies and folic acid and vitamin B12 determinations by an immunoradiometric assay. In the case of serum folic acid, deficiency is moderate in all groups older than 10 years of age of both sexes. Anemia affected the whole group studied, but was especially high in females of all ages, including women older than 40 years, with a prevalence of 80%. A woman who is pregnant and anemic is at risk for having a baby with a low birth weight, a premature baby or even at risk for maternal mortality. For this reason infants, preschoolers and pregnant and childbearing age women are more susceptible to iron deficiency (1,2).


Prevalence of anemia reached values close to 90% for the total population and 100% for boys and girls with less than 3 years of age. The pathophysiology of developing anemia during pregnancy is associated with the fact that the body needs to produce enough nutrients for another life aside from the mother’s.
Plasmodium infection was detected by molecular diagnosis in 53.2% of the cases, and 86% of them were anemic. Folic acid is required for some vital functions such as the synthesis of nucleic acids, blood cells and neural tissue.
In males, iron deficiency was less prevalent than in women, and was higher in children below 3 years of age. For the last few years, data obtained in Venezuela and in other underdeveloped countries, seem to indicate that other factors, besides iron deficiency, could have a role in the reported prevalence of anemia (22). The highest incidence of anemia was found in children, with a prevalence of 100% in infants of both sexes. Regarding folic acid and vitamin B12 deficiencies, the highest prevalence was found in males for both nutrients. The high prevalence of anemia, iron and folic acid deficiencies found, indicates an important health and nutrition problem that should be immediately and properly addressed. Folic acid deficiency is very prevalent in the world and some consequences of this deficiency include: macrocitic or megaloblastic anemia, increased incidence or severity of some types of cancer (5-7), neural tube defects (8,9), increased serum homocysteine levels and cardiovascular alterations (10-12).
The prevalence of folic acid deficiency was high and affected all age groups, while vitamin B12 deficiency was lower and less homogeneous in distribution, showing no cases of deficiency in women older than 40 years of age, probably due to a small sample size (n=52). The cases of anemia that could be due to folic acid deficiency reach 26.7%, using the cutoff of One problem to clarify the origin of the anemia is that ferritin is an acute phase protein, that is elevated in case of infections, and in this population the proportion of anemia produced by iron deficiency could be underestimated, since the diagnosis of iron deficiency was based only on ferritin concentration. In your local supermarket, read the nutritional facts on the cereal and bread you eat and find the ones, especially during your pregnancy, which are high in iron and the necessary vitamins to prevent any complications of anemia. It is possible that the difference found in this study between prevalence of anemia and iron deficiency was due to incidence of infections, especially malaria, with a direct effect not only on erythrocytes, but on serum ferritin concentration. On the other hand, vitamin B12 deficiency is less common and usually affects elderly people and strict vegetarians (3,13). As mentioned before, 53% of the population studied presented malaria infection and from this group, almost 90% was anemic.


Deficiency of this vitamin is recognized for its effect on hematopoyetic and neural systems, causing an important impairment of DNA replication, producing irreversible neuropathy and discontinuous, diffuse and progressive nerve demielinization (14,15).
La mayor incidencia de anemia fue encontrada en niños, con una prevalencia del 100% en lactantes de ambos sexos. A report on 97 preschool and scholar Piaroa children living in 9 Communities of Amazonas State, showed a prevalence of anemia of 80% and 48% in boys and girls, respectively (23). The study of a Yucpa Indigenous community in a western region of Venezuela (24), reported that the prevalence of anemia was 71% and in half of the cases, there was no iron, folic acid or vitamin B12 deficiencies. The prevalence of iron deficiency anemia was 39%, similar to the prevalence found in the present study, and folate deficiency was 12.9%. The authors explain the presence of anemia without iron deficiency, to the incidence of infectious diseases such as hepatitis, parasitic, skin and gastrointestinal tract infections. In another study from the same authors (25) in 2 communities of Bari indians, they report a high prevalence of anemia not due to iron deficiency, attributing the results to nutritional deficiencies and high incidence of infections.
The high prevalence of malaria, anemia, iron and folic acid deficiency indicate a health and nutrition problem in this population, that should be properly and urgently addressed.
Anemia incidence could be due to nutritional deficiencies of iron and folic acid, as well as to malaria. We also thank Venezuelan Air Force for transportation during the study.REFERENCESInternational Anemia Consultative Group (INACG). It is a radioactive method non susceptible to antibiotics and metothrexate that allows the simultaneous determination of folic acid and vitamin B12 concentrations in serum, plasma or blood, which can be calculated from standard curves. Unless otherwise indicated, prevalence of folic acid deficiency refers to cases with severe and moderate deficiency, with a cutoff point Analyses of results were performed calculating the prevalence of anemia and deficiencies of iron, folic acid and vitamin B12 separately and then correlating these deficiencies as causes of anemia, according to age and gender. Biochemical and molecular aberrations in the rat colon due to folate depletion are age-specific. Low-dose vitamin B6 effectively lowers fasting plasma homocysteine in healthy elderly persons who are folate and riboflavin replete.



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