Rapid Response
Folic Acid Fortification and the Risk of Masked Vitamin B12 Deficiency
Abstract
Folic Acid Fortification and the Risk of Masked Vitamin B12 Deficiency
In January 1998, folic acid fortification of cereals was implemented by the United States Food and Drug Administration in an attempt to increase dietary folic acid intake. However, there is a risk of masking or precipitating clinical manifestations related to vitamin B12 deficiency with increasing exposure to folic acid. In their recent report, Wyckoff et al concluded that macrocytosis, once a valuable indicator, could no longer be used as a gauge of vitamin B12 deficiency in the postfolic acid fortification era. This leaves us with the question, how do we assess for vitamin B12 deficiency?
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