Ðe ɖeɖi tea ŋuwò ɣesiaɣia? Mina míasrɔ̃ nusianu tso ʋusɔgbɔdɔ si me folate mele o ŋu!

Ðe ɖeɖi te ŋuwò hã ŋkeke bliboa katã, eye màte ŋu awɔ naneke oa? Alo ɖe nèsena le ɖokuiwò me ɣeaɖewoɣi be yeƒe ŋutilã le vuvɔ wɔm eye gbɔgbɔ sesẽ viea? Esiawo menye nusiwo dzɔna le vome ko o, ɖewohĩ nunyiame si nye folate mele wò ŋutilã me o, si ate ŋu anɔ ʋu ƒe veve, si nye ʋusɔgbɔdɔ, hem vɛ. Egbea, mina míaƒo nu tso nusi ʋusɔgbɔdɔ si me folate mele o nye, nusita wòdzɔna, kple alesi woaƒo asa nɛ ŋu.

Nukae Nye Folate Deficiency Ʋusɔgbɔdɔ? Mina míase egɔme bɔbɔe!

Kpuie ko la, ʋusɔgbɔdɔ si me folate mede o nye ʋusɔgbɔdɔ si tsoa folate, alo vitamin B9, ƒe anyimanɔmanɔ le wò ŋutilã me gbɔ. Nusi dzɔna le esia me enye be ʋumenugbagbevi dzĩ siwo le wò ŋutilã me ƒe xexlẽme le ʋɛ wu alesi wòle be wòanɔ eye ʋumenugbagbevi dzĩ siwo le eme la lolo le mɔ si mesɔ o nu. Bu eŋu kpɔ, ʋumenugbagbevi dzĩ siawo tsɔa ɔksidzin yia míaƒe ŋutilã katã me. Eyata ne lãmenugbagbevi siawo dzi ɖe kpɔtɔ, wova lolo, alo womete ŋu le dɔ wɔm nyuie o la, oxygen si ŋutilãa xɔna la dzi ɖena kpɔtɔna. Le ɣeyiɣi aɖe megbe la, ɔksidzin ƒe anyimanɔmanɔ siae nana ɖeɖi tea ŋuwò, gbɔdzɔna, eye vuvɔ nɔa ŋuwò.

Nukatae ʋusɔgbɔdɔ dzɔna ne folate mesɔ gbɔ o? Nukae dzɔna le ŋutilãa me?

Ènya ale si míaƒe ʋumenugbagbevi dzĩwo dzɔnaea? Wotsoa lãmenugbagbevi siwo le ƒumeŋuɖui si le míaƒe ƒuwo me me gbã. Ʋumenugbagbevi dzĩ siawo tsina vivivi hewɔa ɖeka kple míaƒe ʋu, eye wotsɔa ɔksidzin yia ŋutinu kple lãmenugbagbevi ɖesiaɖe si le ŋutilãa me.

Le afisia la, nunyiame aɖe si woyɔna be folate hiã vevie hafi ʋumenugbagbevi dzĩ siwo le lãmesẽ me nawɔ nyuie. Ele abe xɔ si wotsɔ siminti tu xɔe ene. Eyata ne folate mesu wò ŋutilã o la, wò ƒumeŋuɖui mawɔ ʋumenugbagbevi dzĩ siwo sɔ o. Ke boŋ ewɔa ʋumenugbagbevi dzĩ ƒomevi aɖe si lolo le mɔ si mesɔ o nu si woyɔna be ``megaloblasts.''

Esi wònye be ``megaloblastic'' lãmenugbagbevi siawo lolo ale gbegbe ta la, wo dometɔ aɖewo medona le ƒumeŋuɖui me gɔ̃ hã va kpena ɖe ʋua ŋu o. Lãmenugbagbevi siwo wɔa ɖeka la menɔa agbe didi abe ʋumenugbagbevi dzĩ siwo le lãmesẽ me ene o. Wokuna kaba. Esia tae ʋumenugbagbevi dzĩwo ƒe xexlẽme dzi ɖena kpɔtɔna le ŋutilãa me, si wɔnɛ be ʋusɔgbɔdɔ, si fia be ʋu mesɔ gbɔ o. Èse egɔmea?

Ðe ʋusɔgbɔdɔ ƒomevi bubuwo lia?

Ẽ, ʋusɔgbɔdɔ nye dɔléle si bɔ si ame geɖe ate ŋu adze. Ʋumenugbagbevi dzĩ siwo le lãmesẽ me ƒe anyimanɔmanɔ gbɔe wòtsona. Nu geɖe li siwo gbɔ ʋusɔgbɔdɔ tsona:

• Ʋumenugbagbevi dzĩ siwo lolo le mɔ si mesɔ o nu (esia hã tso folate ƒe anyimanɔmanɔ si ŋu míele nu ƒom tsoe gbɔ).
• Ʋumenugbagbevi dzĩ siwo le lãmesẽ me ƒe wɔwɔme dzi ɖe kpɔtɔ.
• Ʋumenugbagbevi dzĩwo tsɔtsrɔ̃ fũ akpa to aklã kple dɔgbo dzi.
• Hemoglobin, si nye protein si le ʋumenugbagbevi dzĩwo me si tsɔa ɔksidzin, ƒe agbɔsɔsɔ dzi ɖe kpɔtɔ.
• Hemoglobin mele dɔ wɔm nyuie o, si fia be mate ŋu alé oxygen nyuie o.
• Ʋumenugbagbevi dzĩwo ƒe gbagbã le ʋua me.

Woyɔa ʋusɔgbɔdɔ ƒe ƒuƒoƒo si ʋumenugbagbevi dzĩ siwo lolo le mɔ si mesɔ o nu hena vɛ be ``macrocytic anemia``. Esia ƒomevi ɖekae nye ``megaloblastic anemia``. Nusiwo gbɔna la dzena le ``megaloblastic anemia`` sia te:

• Folate ƒe anyimanɔmanɔ ƒe ʋusɔgbɔdɔ
• Vitamin B12 ƒe anyimanɔmanɔ ƒe ʋusɔgbɔdɔ
• Ʋusɔgbɔdɔ si gblẽa nu le ame ŋu

Tsɔ kpe ɖe esia ŋu la, ʋusɔgbɔdɔ ƒomevi bubu siwo ŋu ame geɖe se nu tsoe nye:

• Ʋusɔgbɔdɔ si me iron mele o
• Ʋusɔgbɔdɔ si woyɔna be sickle cell

Aleke gbegbee folate ƒe anyimanɔmanɔ bɔe?

Folate ƒe anyimanɔmanɔ mebɔ nenema gbegbe le dukɔ deŋgɔwo me o. Esia le alea elabena wotsɔa folate dea nuɖuɖu geɖe me le dukɔ mawo me. Le kpɔɖeŋu me, le United States la, enye sedziwɔwɔ be woatsɔ folate akpe ɖe nuɖuɖuwo ŋu tso ƒe 1998. Nusitae nye be folate le vevie ŋutɔ na ɖevia ƒe tsitsi le fugboe ƒe ɣeyiɣia me.

Ðɔktawo kpɔe be folate ƒe anyimanɔmanɔ ate ŋu ahe vidzidzi ƒe gbɔdzɔgbɔdzɔ aɖewo vɛ, vevietɔ ahɔhɔ̃mekawo ƒe dɔmawɔmawɔ nyuie abe spina bifida ene. Esia tae le dukɔ geɖe me la, wotsɔa folate dea nuɖuɖu geɖe siwo míeɖuna me, vevietɔ nukuwo kple bli.

Amekawoe le afɔku gã me be woaxɔ ʋusɔgbɔdɔ si me folate mele o?

Ame aɖewo li siwo ŋu dɔléle sia ate ŋu adze bɔbɔe wu. Kpɔe ɖa be èdze le hatsotso sia me hã:

• Nyɔnu siwo xɔ ƒe si woate ŋu adzi vi: Folate ƒe hiahiã sɔ gbɔ ŋutɔ na nyɔnu siwo le ɖoɖo wɔm be yewoafɔ fu, le fufɔɣi, kple no nana wo.
• Ame siwo noa aha fũu akpa: Ahanono gblẽa nu le ŋutilã ƒe ŋutete be wòaxɔ nunyiamewo ŋu.
• Ame siwo xɔ wu ƒe 60.
• Ame siwo ganyawo sesẽ: Elabena esesẽna be woaƒle nuɖuɖu si da sɔ.
• Vidada siwo fɔ fu kple esiwo le no nam vi.

Nukae hea ʋusɔgbɔdɔ si folate ƒe anyimanɔmanɔ vɛ?

Susu vevitɔe nye be míekpɔa folate si sɔ gbɔ tso nuɖuɖu siwo míeɖuna me o. Tsɔ kpe ɖe eŋu la, susu bubuwo li siwo tae ŋutilãa mete ŋu xɔa folate alo zãnɛ nyuie o:

• Ahanono ƒe numame (`Ahanono ƒe kuxi`).
• Dialysis dɔdamɔnu wɔwɔ le ayiku ƒe dɔmawɔmawɔ nyuie ta.
• Nuɖuɖumeŋusẽ ƒe dɔlélewo, le kpɔɖeŋu me, Crohn ƒe dɔléle kple celiac dɔléle.
• Atike aɖewo zazã ɣeyiɣi didi (e.g., na asrã, lãmekawo ƒe dɔléle, dɔlékuiwutike aɖewo, kple dɔlélenutsiŋutete).
• Domenyinyi ƒe nɔnɔmewo abe ``Hereditary folate malabsorption`` (si me ŋutilã ƒe ŋutete be wòaxɔ folate dzi ɖena kpɔtɔna tso edziɣi).

Nukae nye esia ƒe dzesiwo? Aleke nèwɔ dea dzesii?

Ɣeaɖewoɣi la, ʋusɔgbɔdɔ si me folate mele o ate ŋu anɔ ame ŋu dzesi aɖeke manɔmee. Ðewohĩ ne wodo wò ʋu kpɔ be nu bubu aɖe le ŋuwò ko hafi wò ɖɔkta akpɔe.

Gake ne dzesiawo dze la, woate ŋu anye:

• Ðeɖiteameŋu ƒe seselelãme ɣesiaɣi (`ɖeɖiteameŋu`): Ele abe ɖe ɖeɖiteameŋua medzona le alɔ̃dɔdɔ vɔ megbe gɔ̃ hã o ene.
• Sese le eɖokui me be yele kuvia wɔm eye yegbɔdzɔ esime yele gbesiagbedɔwo wɔm.
• Taɖuame, sese le ame ɖokui me be tagbɔ le ƒoƒom.
• Ŋutilã si le ɣie (`pallor`): Teƒe siwo le abe mo, nuyiwo, kple asibidɛwo ene dzena abe ɖe wole ɣie ene.
• Sese le ɖokuiwò me abe wò dzi le ƒoƒom kabakaba ene, gbeɖiɖi aɖe si le ƒoƒom le wò akɔta sese, alo sese le ɖokuiwò me abe ɖe wò dzi le tsotsom ene (dzi ƒe tsotso).
• Yagbɔgbɔ sesẽ (gbɔgbɔmeʋuʋu): Gbɔgbɔ kpuie ne wowɔ dɔ suewo gɔ̃ hã.

Aleke wowɔna dea dzesi dɔléle sia pɛpɛpɛ ?

Ne dzesi siawo le ŋuwò la, ele be nàyi ɖɔkta gbɔ godoo. Wò ɖɔkta awɔ wò ŋutilã dodokpɔ eye wòabia wò atikewɔwɔ ŋutinya kple dzesiwo. Esi wònye be ʋusɔgbɔdɔ si me folate mele o ƒe dzesiwo sɔ kple nɔnɔme bubu geɖe ta la, ahiã be woado ʋu kpɔ zi geɖe be nànya nenye be ele alea.

Ʋudodokpɔ siawo dometɔ vevitɔwoe nye:

• Ʋu ƒe xexlẽme blibo (CBC): Esia léa ŋku ɖe nu geɖe ŋu, abe ʋumenugbagbevi dzĩwo, ʋumenugbagbevi ɣiwo, kple ʋumenugbagbevi dzĩwo ƒe xexlẽme le wò ʋu me, kpakple ʋumenugbagbeviɣi ƒe agbɔsɔsɔ hã.
• Peripheral blood smear (PBS): Esia bia be woaɖe wò ʋu aɖe ahalé ŋku ɖe eŋu le nusuekpɔmɔ̃ me. Esia wɔnɛ be nàte ŋu akpɔ nɔnɔme si tututu ʋumenugbagbeviawo le, ne wololo alo le sue, kple ne nanewo mesɔ o.
• Reticulocyte ƒe xexlẽme: Reticulocyte nye ʋumenugbagbevi dzĩ siwo metsi o. Dodokpɔ sia léa ŋku ɖe wò ƒumeŋuɖui le ʋumenugbagbevi dzĩwo wɔm wòsɔ gbɔ hã.

Tsɔ kpe ɖe dodokpɔ siawo ŋu la, wò ɖɔkta akpɔ folate ƒe agbɔsɔsɔ le wò ʋu me hã. Zi geɖe la, wodzidzea esia le xexlẽdzesi siwo woyɔna be `nanograms per milliliter` (`ng/mL`) me.

• Nusiwo mehiã o: Mede nanogram 2 le mililita ɖeka me (`< 2 ng/mL`).
• Liƒo: Nanogram 2 kple 4 dome le mililita ɖeka me (`2 ng/mL - 4 ng/mL`).
• Esɔ gbɔ: Elolo wu nanogram 4 le mililita ɖeka me (`> 4 ng/mL`).

Esi wònye be vitamin B12 ƒe anyimanɔmanɔ kple folate ƒe anyimanɔmanɔ ate ŋu adzɔ ɖekae zi geɖe ta la, ɖɔktaa akpɔ wò vitamin B12 ƒe agbɔsɔsɔ hã.

Nukawoe nye atike siwo wozãna na esia?

Nya nyuiae nye be, atikewɔwɔ li na esia, eye wòkpɔa dzidzedze ŋutɔ.

Atikewɔwɔ vevitɔe nye be woana vitamin B9 ƒe kpeɖeŋutɔ.Zi geɖe la, wonaa esiawo abe atikekui siwo woano to nu me ene. Le ame aɖewo siwo ƒe atikekuiwo mimi sesẽna gome la, woate ŋu ado wo hã abe atike ene, alo woado wo ɖe ʋuka me (IV) kple saline. Ðewohĩ ahiã be woano kpeɖeŋutɔtike siawo atraɖii hena ɣleti geɖe.

Wò ɖɔkta ate ŋu aɖo aɖaŋu na wò hã be nàtrɔ asi le wò nuɖuɖu ŋu. Ne atikewɔwɔ me nɔnɔme aɖe si gbɔ wòtso gbɔe folate ƒe anyimanɔmanɔ tso la, ele vevie be woada dɔléle ma hã.

Ðe woate ŋu axe mɔ ɖe ʋusɔgbɔdɔ si me folate mele o nua?

Ẽ, anya wɔ godoo. Ele bɔbɔe be nàƒo asa na nɔnɔme sia ne èlé be na nusiawo:

• Na folate ƒe agbɔsɔsɔme si nèzãna gbesiagbe nasu asiwò, to nuɖuɖu siwo nèɖuna dzi alo to atike si me vitamin B9 (folic acid) le nono me.
• Ðe aha sesẽ si nènona dzi kpɔtɔ, alo dzudzɔ enono kura. Ahanono fũu akpa xea mɔ na ŋutilãa mexɔa nunyiame veviwo, siwo dome folate hã le o.
• Ne dɔléle aɖe le ŋuwò si xea mɔ na wò ŋutilã be wòate ŋu axɔ folate alo azãe la, ƒo nu tso eŋu na wò ɖɔkta.

Folate (vitamin B9) agbɔsɔsɔme kae míehiã gbesiagbe?

Vitamin B9 si míekpɔna le dzɔdzɔme nu tso nuɖuɖu me la woyɔna be folate. Woyɔa vitamin B9 si wotsɔ dea nuɖuɖu me alo le vitamin-tikewo me be folic acid. Folate agbɔsɔsɔme si míehiã gbesiagbe nɔ te ɖe nu geɖe dzi:

• Ƒe: Ne èle tsitsim la, folate ƒe hiahiã dzina ɖe edzi.
• Nuɖuɖutsoƒe: Míaƒe ŋutilã xɔa folic acid nyuie wu folate si le nuɖuɖu me.

Woɖea Gbesiagbe Gakpekpeɖeŋu si Wokafu (RDA) fiana le microgram (mcg) me, si wodzidzena le Dietary Folate Equivalents (DFE) me. Esia adze nusi tɔtɔa ame vie, gake ele bɔbɔe.

• `1 mcg` ƒe folate tso nuɖuɖu me sɔ kple `1 mcg DFE`.
• Eɖanye be èxɔ folic acid si wotsɔ kpe ɖe nuɖuɖu ŋu alo tso vitamin-tike siwo nèno kpe ɖe nuɖuɖu ŋu me o, folic acid mcg 1 sɔ kple DFE mcg 1.67 (si fia be ŋutilãa xɔa nu geɖe).
• Folic acid mcg 1 si tso vitamin-tike siwo wono le dɔgbo ƒuƒlu me sɔ kple DFE mcg 2 (si ŋutilãa xɔa nyuie wu gɔ̃ hã).

Le kpɔɖeŋu me, ne èno vitamin geɖe si me folic acid `200 mcg` le le ƒodo ƒuƒlu me la, woate ŋu abui be enye `400 mcg DFE` (200 mcg x 2 = 400 mcg).

Ame tsitsi le mama dedie nu hiã DFE mcg 400 gbesiagbe. Funɔwo hiã DFE mcg 600, eye vidada siwo le no nam viwo hiã DFE mcg 500. Anyo wu be nàbia wò ɖɔkta be wòagblɔ agbɔsɔsɔ si sɔ na wò.

Nuɖuɖu kawoe me folate sɔ gbɔ ɖo?

Dzɔgbenyuietɔe la, nuɖuɖu geɖe li siwo nye folate dzɔtsoƒe nyuiwo. Tee kpɔ nàtsɔ esiawo akpe ɖe wò nuɖuɖu ŋu:

• Lãwo: Nyilã ƒe aklã (esia sɔ gbɔ, gake ele be nàbu ʋumemi hã ŋu) .
• Amagbe damawo kple gbetikewo: Amagbe damawo abe aŋanyi, kale, collard greens, asparagus, Brussels sprouts, avocado, broccoli.
• Nuɖuɖu siwo me wodoa ŋusẽe: Nuku aɖewo (ŋdi me nukuwo), bli, abolo, pasta, abolowɔ, bli. (Kpɔ nusi woŋlɔ ɖe edzi ɖa be wotsɔ folic acid kpe ɖe eŋu hã.)
• Gbe: Ayiku me gbe, ayiku me gbe.
• Nutsetsewo: Atikutsetse, walnuts.
• Atikutsetse: Citrus-kutsetsewo abe amititsetse kple tangerine kple woƒe detsiƒonuwo.

Ðo ŋku edzi be: Folate ate ŋu agblẽ ne woɖa nuɖuɖu siawo ɣeyiɣi didi, abe ne woɖa wo le tsi me ene. Eyata ɖa wo vie alesi nàte ŋui, alo nàtsɔ wo akpe ɖe wò nuɖuɖu ŋu ne woate ŋu aɖu wo ƒuƒui (woaklɔ wo nyuie).

Ðe nɔnɔme sia ada ne wodaea?

Anɔ eme godoo be ẽ! Zi geɖe la, ʋusɔgbɔdɔ si me folate mele o dada kpɔa dzidzedze ŋutɔ. Le ɣleti ʋɛ aɖewo megbe tso esime ame akpa gãtɔ dze vitamin B9 kpeɖeŋutɔ nana gɔme la, wogadzea ʋumenugbagbevi dzĩ siwo le lãmesẽ me wɔwɔ gɔme ake, eye woƒe dzesiwo nyona ɖe edzi vivivi.

Ɣekaɣie wòle be nàƒo nu kple ɖɔkta tso ʋusɔgbɔdɔ si me folate mele o ŋu?

Kpɔ egbɔ be yedi atikewɔlawo ƒe aɖaŋuɖoɖo le nya siawo tɔgbe me:

• Ne mèka ɖe folate agbɔsɔsɔme si nèhiã gbesiagbe dzi o, alo ne èle ekpɔm wòsɔ gbɔ.
• Ne ʋusɔgbɔdɔ ƒe dzesiwo le ŋuwò (abe ɖeɖiteameŋu, gbɔdzɔgbɔdzɔ, gbɔgbɔtsixetsixe ene).
• Ne atikewɔwɔ me dɔléle bubu aɖe le ŋuwò si ate ŋu ana folate nagbɔdzɔ.
• Ne woda dɔ na wò va yi le ʋusɔgbɔdɔ si me folate mede o ta eye nèse le ɖokuiwò me be yeƒe dzesiwo le tɔtrɔm.
• Ne èle ɖoɖo wɔm be yeafɔ fu, alo èfɔ fu xoxo. Esia le vevie ŋutɔ!

Ate ŋu atɔtɔ vie ne èse be kuxi aɖe le wò ʋumenugbagbeviɣiwo ŋu. Gake ɖo ŋku edzi be dzesiwo nye alesi wò ŋutilã gblɔna na wò be nane gblẽ. Ate ŋu anye be èhiã nuɖuɖu si da sɔ, alo ate ŋu anye atikewɔwɔ me dɔléle aɖe si gbɔ wòtso. Wò ɖɔkta awɔ dɔ kpli wò akpɔ nusi gbɔ wòtso. Woaŋlɔ vitamin B9 kpeɖeŋutɔ kple atike bubuwo hã ne ehiã. Ne wowɔ atike na wò nyuie eye nèwɔ ɖe wò ɖɔkta ƒe mɔfiamewo dzi la, anɔ eme godoo be wò dzesiwo anyo ɖe edzi.

Nu vevitɔ kekeake siwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Enyo, eyata nu aɖewo siwo wòle be wòanɔ susu me na mí tso nusiwo ŋu míeƒo nu tsoe me lae nye esi:

• Folate (vitamin B9) nye nunyiame vevi aɖe si woatsɔ awɔ ʋumenugbagbevi dzĩ siwo le lãmesẽ me.
• Folate ƒe anyimanɔmanɔ ate ŋu ana ʋumenugbagbevi dzĩ gã siwo mesɔ o (`megaloblasts`) nadzɔ, si ahe ʋusɔgbɔdɔ vɛ.
• Ne èkpɔ dzesiwo abe ɖeɖiteameŋu ɣesiaɣi, gbɔdzɔgbɔdzɔ, ŋutigbalẽ ƒe ɣie, kple gbɔgbɔ sesẽ ene la, yi ɖɔkta gbɔ.
• De nuɖuɖu siwo me folate sɔ gbɔ ɖo (mɔli, amagbe damawo, nukuwo, nuɖuɖu siwo me wotsɔ folate kpe ɖe eŋu) de wò nuɖuɖu me.
• Ele be funɔwo, no nana vi, kple nyɔnu siwo le agbagba dzem be yewoafɔ fu nakpɔ nyuie le folate ŋu vevietɔ. No folic acid ƒe atikekuiwo abe alesi wò ɖɔkta gblɔe ene.
• Zi geɖe la, woate ŋu ada nɔnɔme sia keŋkeŋ to atikewɔwɔ me.

Eyata, lé be na wò ŋutilã. Ƒo nuɖuɖu si da sɔ. Ne kuxi aɖewo le ŋuwò la, mègavɔ̃ be yeaƒo nu kple ɖɔkta o. Lãmesẽ me nɔnɔe nye nu vevitɔ kekeake!

` Folate, ʋusɔgbɔdɔ, vitamin B9, ʋu ƒe veve, ʋumenugbagbevi dzĩwo, nunyiame ƒe veve, fufɔfɔ ƒe lãmesẽ