Pernicious Anemia Masked by Multivitamins Containing Folic Acid

The danger of administering folic acid preparations without specific indications is illustrated by two case histories. Two women, aged 58 and 70 years, complained of paresthesias, difficulty in walking, and other neurological symptoms. The diagnosis of pernicious anemia as the underlying disease was not clear until it was discovered that the first patient had been taking folic acid preparations daily for more than two years; the other had been doing so for more than a month. After the correct diagnosis had been made, use of the folic acid was discontinued, and treatment with liver extract and vitamin B 12 was followed by some relief of the neurological symptoms. A plea is made for the elimination of folic acid from multivitamin and iron preparations.