Malabsorption of Folate Polyglutamates Associated with Oral Contraceptive Therapy

DRUG-induced malabsorption of the dietary form (folate polyglutamates) of folic acid has been recognized as a possible cause of megaloblastic anemia.1 , 2 The drug studied was diphenylhydantoin, but Streiff3 has suggested that oral contraceptive agents may have a similar effect. We wish to describe two women in whom folate-responsive megaloblastic anemia appeared after prolonged therapy with oral contraceptives. In both cases, as well as in four healthy women, therapy with contraceptive agents suppressed the rise in serum folate levels that usually follow ingestion of folate polyglutamates.Case 1. D.P., a 45-year-old woman, was well until 2 months before admission, when fatigue . . .