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Signs of folate deficiency anemia most of the time are subtle. [4] Anemia (macrocytic, megaloblastic anemia) can be a sign of advanced folate deficiency in adults. [1] Folate deficiency anemia may result in feeling tired, weakness, changes to the color of the skin or hair, open sores on the mouth, shortness of breath, palpitations, lightheadedness, cold hands and feet, headaches, easy bleeding ...
Both high-folate diets and supplemental folic acid may help reduce the toxic side-effects of low-dose methotrexate without decreasing its effectiveness. [ 8 ] [ 9 ] Anyone taking low-dose methotrexate for the health problems listed above should consult with a physician about the need for a folic acid supplement.
Research suggests that levomefolic acid (L-methylfolate) taken with a first-line antidepressant [6] provides a modest adjunctive antidepressant effect for individuals who do not respond or have only a partial therapeutic response to SSRI or SNRI medication, [7] [8] and might be a more cost-effective adjunctive agent than second-generation antipsychotics.
Cerefolin is a prescription medication made by Pamlab that contains 5.635 mg of folate as L-methylfolate, 1 mg of vitamin B 12 as methylcobalamin, 50 mg of vitamin B 2 as riboflavin, and 5 mg of vitamin B 6 as pyridoxine. It is approved by the U.S. Food and Drug Administration for the treatment or prevention of vitamin deficiencies. [1]
However, methotrexate can be toxic, [56] [57] [58] producing side effects such as inflammation in the digestive tract that make eating normally more difficult. Bone marrow depression (inducing leukopenia and thrombocytopenia) and acute kidney and liver failure have been reported.
Side effects common to both SNRIs include anxiety, restlessness, nausea, weight loss, insomnia, dizziness, drowsiness, sweating, dry mouth, sexual dysfunction and weakness. [122] In comparison to SSRIs, the SNRIs have a higher prevalence of the side effects of insomnia, dry mouth, nausea and high blood pressure.