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The Continued Need for the Routine Assessment of Folate Status.
Bremansu Osa-Andrews1, Melissa Sanchez2, Ibrahim A Hashim1,2
1Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Laboratory Medicine
|January 13, 2023
Summary
Blood folate testing remains necessary in some cases, even with supplementation recommendations. This study found deficiencies and combined anemias, indicating local assessment is crucial.
Area of Science:
- Clinical Chemistry
- Hematology
Background:
- The Choosing Wisely initiative suggested stopping folate testing, recommending supplementation for macrocytic anemia.
- This recommendation may not suit all patient populations.
Purpose of the Study:
- To evaluate the necessity of continued red blood cell (RBC) folate testing.
- To assess folate levels in conjunction with other relevant biomarkers at a large SafetyNet hospital.
Main Methods:
- Retrospective review of RBC folate, vitamin B12, iron, ferritin, and hemoglobin results.
- Utilization review of laboratory data.
Main Results:
- 11.7% of RBC folate tests showed deficiency, and 5% were high.
- A significant portion of patients had low hemoglobin (70%) and iron levels (59%).
- Iron deficiency anemia and combined folate and iron deficiency anemias were identified.
Conclusions:
- National recommendations may not be universally applicable.
- Institutions should evaluate local data to determine the need for specific laboratory tests like folate.
- Continued RBC folate testing may be warranted based on local patient demographics and disease prevalence.
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