{"id":21458,"date":"2024-10-03T11:28:52","date_gmt":"2024-10-03T09:28:52","guid":{"rendered":"https:\/\/bmscience.net\/blog\/?p=21458"},"modified":"2026-01-24T16:18:25","modified_gmt":"2026-01-24T15:18:25","slug":"lanemia-da-carenza-di-folati","status":"publish","type":"post","link":"https:\/\/bmscience.net\/blog\/lanemia-da-carenza-di-folati\/","title":{"rendered":"L&#8217;anemia da carenza di folati"},"content":{"rendered":"<div class=\"wp-block-image\">\n<figure class=\"alignleft size-full is-resized\"><a href=\"https:\/\/amzn.to\/47Tr5N5\"><img loading=\"lazy\" decoding=\"async\" width=\"522\" height=\"855\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/10\/51LjhrQqaL._AC_SX522_.jpg\" alt=\"\" class=\"wp-image-21459\" style=\"width:152px;height:auto\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/10\/51LjhrQqaL._AC_SX522_.jpg 522w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/10\/51LjhrQqaL._AC_SX522_-183x300.jpg 183w\" sizes=\"auto, (max-width: 522px) 100vw, 522px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p>L\u2019anemia da carenza di folato \u00e8 la causa pi\u00f9 comune di <strong><a href=\"https:\/\/bmscience.net\/blog\/2024\/05\/15\/le-anemie-megaloblastiche-megaloblastosi\/\" data-type=\"post\" data-id=\"20917\">anemia megaloblastica<\/a><\/strong>, una condizione caratterizzata dalla presenza di globuli rossi anormalmente grandi.<\/p>\n\n\n\n<p>L\u2019<strong>acido folico<\/strong>, o folato, \u00e8 una vitamina essenziale che si ottiene principalmente da vegetali, frutta secca e prodotti animali. Viene assorbito nel duodeno e, in particolare, nel digiuno. All&#8217;interno delle cellule intestinali, il folato (nella sua forma inattiva) viene convertito in <strong>acido folinico<\/strong> o <strong>tetraidrofolico<\/strong> (la forma attiva) grazie all&#8217;azione degli enzimi folato reduttasi. Questa forma attiva entra poi in circolo e si accumula nel fegato, dove pu\u00f2 essere immagazzinata per 3-4 mesi, e negli eritroblasti.<\/p>\n\n\n\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_83 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title ez-toc-toggle\" style=\"cursor:pointer\">Indice<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #222222;color:#222222\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #222222;color:#222222\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/bmscience.net\/blog\/lanemia-da-carenza-di-folati\/#Eziologia\" >Eziologia<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/bmscience.net\/blog\/lanemia-da-carenza-di-folati\/#Segni_clinici\" >Segni clinici<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/bmscience.net\/blog\/lanemia-da-carenza-di-folati\/#Diagnosi\" >Diagnosi<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/bmscience.net\/blog\/lanemia-da-carenza-di-folati\/#Trattamento\" >Trattamento<\/a><\/li><\/ul><\/nav><\/div>\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Eziologia\"><\/span>Eziologia<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n<div id=\"bmscience2374807591\" style=\"margin-top: 15px;margin-left: 15px;float: right;\"><a href=\"https:\/\/amzn.to\/44sunFE\" target=\"_blank\" aria-label=\"Version 1.0.0\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/3c9ca780-635b-4c7e-9b5b-eb0e52844525.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/3c9ca780-635b-4c7e-9b5b-eb0e52844525.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/3c9ca780-635b-4c7e-9b5b-eb0e52844525-180x150.jpg 180w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" width=\"300\" height=\"250\"   \/><\/a><\/div>\n\n\n<p>Le cause principali dell\u2019anemia da carenza di folato includono:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>diminuzione dell\u2019apporto<\/strong>: dieta inadeguata e alcolismo, una delle cause pi\u00f9 frequenti di macrocitosi in Italia, con o senza anemia;<\/li>\n\n\n\n<li><strong>aumento del fabbisogno<\/strong>: gravidanza (soprattutto nel terzo trimestre) e malattie con ricambio cellulare eccessivo come psoriasi, anemie emolitiche croniche, ipertiroidismo e neoplasie;<\/li>\n\n\n\n<li><strong>malassorbimento<\/strong>: enteropatie (come steatorrea e neoplasie) e l\u2019uso di farmaci come anticonvulsivanti, barbiturici e anticoncezionali;<\/li>\n\n\n\n<li><strong>alterazioni metaboliche<\/strong>: inibizione dell\u2019enzima diidrofolato reduttasi da farmaci come metotrexato e cotrimoxazolo, e antagonisti delle purine e pirimidine come la 6-mercaptopurina,<\/li>\n\n\n\n<li><strong>aumento delle perdite<\/strong>: epatopatia cronica, emodialisi e enteropatia con perdita di proteine.<\/li>\n<\/ul>\n\n\n<div id=\"bmscience3276727891\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/4n3hOt1\" target=\"_blank\" aria-label=\"9b0b9447-4770-4713-8589-c51ab09f1323\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/9b0b9447-4770-4713-8589-c51ab09f1323-scaled.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/9b0b9447-4770-4713-8589-c51ab09f1323-scaled.jpg 2560w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/9b0b9447-4770-4713-8589-c51ab09f1323-300x65.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/9b0b9447-4770-4713-8589-c51ab09f1323-1024x221.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/9b0b9447-4770-4713-8589-c51ab09f1323-768x166.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/9b0b9447-4770-4713-8589-c51ab09f1323-1536x332.jpg 1536w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/9b0b9447-4770-4713-8589-c51ab09f1323-2048x443.jpg 2048w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\" width=\"2560\" height=\"553\"  style=\"display: inline-block;\" \/><\/a><\/div>\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Segni_clinici\"><\/span>Segni clinici<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>I segni clinici dell\u2019anemia da carenza di folato sono simili a quelli della <a href=\"https:\/\/bmscience.net\/blog\/2024\/05\/15\/anemia-megaloblastica-da-carenza-di-vitamina-b12\/\" data-type=\"post\" data-id=\"20924\">carenza di vitamina B<sub>12<\/sub><\/a>, ma di solito senza manifestazioni neurologiche.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Diagnosi\"><\/span>Diagnosi<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright size-full is-resized\"><a href=\"https:\/\/amzn.to\/3G3UE4K\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"602\" height=\"853\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/51eg3Zn5GL.jpg\" alt=\"\" class=\"wp-image-24121\" style=\"width:147px;height:auto\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/51eg3Zn5GL.jpg 602w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/51eg3Zn5GL-212x300.jpg 212w\" sizes=\"auto, (max-width: 602px) 100vw, 602px\" \/><\/a><figcaption class=\"wp-element-caption\"><strong><a href=\"https:\/\/amzn.to\/3O1N8s4\" target=\"_blank\" rel=\"noreferrer noopener\">Acquista ora<\/a><\/strong><\/figcaption><\/figure>\n<\/div>\n\n\n<p>La diagnosi si basa su:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>megaloblastosi<\/strong>: rilevabile mediante aspirato del midollo osseo, anche se raramente eseguito;<\/li>\n\n\n\n<li><strong>livelli di folato<\/strong>: riduzione del folato intraeritrocitario (&lt;100 ng\/mL) e del folato sierico (&lt;3 ng\/mL). Il folato intraeritrocitario \u00e8 un indicatore affidabile dei depositi cellulari di folato poich\u00e9 non attraversa la membrana eritrocitaria;<\/li>\n\n\n\n<li><strong>aumento dell\u2019omocisteina plasmatica<\/strong>.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Trattamento\"><\/span>Trattamento<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Il trattamento dell\u2019anemia da carenza di folato include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>acido folico per os<\/strong>: 1 mg\/giorno, anche se si somministrano dosi di 5 mg\/giorno, equivalenti al contenuto delle compresse;<\/li>\n\n\n\n<li>i<strong>n caso di malassorbimento<\/strong>: somministrazione di acido folico orale e, se non efficace, acido folinico parenterale (1 mg\/giorno);<\/li>\n\n\n\n<li><strong>in caso di assunzione di farmaci che alterano gli enzimi folato reduttasi<\/strong>: somministrazione di acido folinico orale o parenterale. L\u2019acido folico viene somministrato profilatticamente a donne in gravidanza, prematuri e pazienti con anemie emolitiche croniche per prevenire crisi megaloblastiche.<\/li>\n<\/ul>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>Fonte: <a href=\"https:\/\/amzn.to\/3O1N8s4\" target=\"_blank\" rel=\"noreferrer noopener\">Manuale di ematologia. Concorso Nazionale SSM.<\/a><\/p>\n<\/blockquote>\n\n\n<div id=\"bmscience749479966\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><div data-id='24174' class='amazon-auto-links aal-js-loading'><p class='now-loading-placeholder'>Caricamento&#8230;.<\/p><\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>L\u2019anemia da carenza di folato \u00e8 la causa pi\u00f9 comune di anemia megaloblastica, una condizione caratterizzata dalla presenza di globuli rossi anormalmente grandi. L\u2019acido folico, o folato, \u00e8 una vitamina essenziale che si ottiene principalmente da vegetali, frutta secca e prodotti animali. Viene assorbito nel duodeno e, in particolare, nel digiuno. All&#8217;interno delle cellule intestinali,&hellip;<\/p>\n<p class=\"more\"><a class=\"more-link\" href=\"https:\/\/bmscience.net\/blog\/lanemia-da-carenza-di-folati\/\">Continue reading <span class=\"screen-reader-text\">L&#8217;anemia da carenza di folati<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":16866,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advgb_blocks_editor_width":"","advgb_blocks_columns_visual_guide":"","footnotes":""},"categories":[56],"tags":[175,8951,505,3244,8682,8952,8679],"class_list":["post-21458","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ematologia","tag-acido-folico","tag-acido-folinico","tag-anemia","tag-folati","tag-folato","tag-malassorbimento","tag-megaloblastosi","entry"],"author_meta":{"display_name":"Raffo Coco","author_link":"https:\/\/bmscience.net\/blog\/author\/raffo\/"},"featured_img":"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2021\/07\/Anemia-300x217.jpg","coauthors":[],"tax_additional":{"categories":{"linked":["<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/ematologia\/\" class=\"advgb-post-tax-term\">Ematologia<\/a>"],"unlinked":["<span class=\"advgb-post-tax-term\">Ematologia<\/span>"]},"tags":{"linked":["<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/ematologia\/\" class=\"advgb-post-tax-term\">acido folico<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/ematologia\/\" class=\"advgb-post-tax-term\">acido folinico<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/ematologia\/\" class=\"advgb-post-tax-term\">Anemia<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/ematologia\/\" class=\"advgb-post-tax-term\">folati<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/ematologia\/\" class=\"advgb-post-tax-term\">folato<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/ematologia\/\" class=\"advgb-post-tax-term\">malassorbimento<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/ematologia\/\" class=\"advgb-post-tax-term\">megaloblastosi<\/a>"],"unlinked":["<span class=\"advgb-post-tax-term\">acido folico<\/span>","<span class=\"advgb-post-tax-term\">acido folinico<\/span>","<span class=\"advgb-post-tax-term\">Anemia<\/span>","<span class=\"advgb-post-tax-term\">folati<\/span>","<span class=\"advgb-post-tax-term\">folato<\/span>","<span class=\"advgb-post-tax-term\">malassorbimento<\/span>","<span class=\"advgb-post-tax-term\">megaloblastosi<\/span>"]}},"comment_count":"0","relative_dates":{"created":"Pubblicato 2 anni fa","modified":"Aggiornato 4 mesi fa"},"absolute_dates":{"created":"Pubblicato il 03\/10\/2024","modified":"Aggiornato il 24\/01\/2026"},"absolute_dates_time":{"created":"Pubblicato il 03\/10\/2024 11:28","modified":"Aggiornato il 24\/01\/2026 16:18"},"featured_img_caption":"","series_order":"","_links":{"self":[{"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/posts\/21458","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/comments?post=21458"}],"version-history":[{"count":0,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/posts\/21458\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/media\/16866"}],"wp:attachment":[{"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/media?parent=21458"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/categories?post=21458"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/tags?post=21458"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}