I chau reng em? Folate tlakchhamna thisen tlakchhamna chungchang hi i zir vek ang u!

Nilengin i chau bawk a, engmah ti thei loin i inhria em? Nge, a chang chuan i taksa chu a vawt a, thawk a harsa deuh niin i hria em? Hengte hi random thil mai a ni lo va, i taksaah nutrient folate a tlachham mai thei a, chu chuan thisen tlakchhamna, chu chu thisen tlakchhamna a thlen thei a ni. Vawiin hian folate tlakchhamna thisen tlakchhamna (folate deficiency anemia) chu eng nge a nih, engvangin nge a lo awm tih leh a pumpelh dan tur kan sawi dawn a ni.

Folate tlakchhamna hi eng nge ni? A awlsam zawngin i hrethiam ang u!

A awlsam zawngin sawi ila, folate tlakchhamna thisen tlakchhamna hi i taksaa folate, a nih loh leh vitamin B9 tlakchham vang a ni. Hemi a thil thleng chu i taksaa thisen zam (red blood cells) awm zat chu a pangngai aia tlem a, a awm thin thisen sen (red blood cells) chu a pangngai lo takin a tam a ni. Ngaihtuah teh, heng thisen sen (red blood cells) te hian kan taksa pum puiah oxygen an phur a. Chuvangin heng cell te hi an tlem a, an lo lian a, an thawk tha thei lo a nih chuan taksain oxygen a dawn zat chu a tlahniam thin. Hun a kal zel a, he oxygen tlakchhamna hian i chau a, i chak lo a, i vawt bawk.

Engvangin nge folate a tlakchham hian thisen tlakchhamna (anemia) a awm? Taksa chhungah eng thil nge thleng?

Kan thisen sen (red blood cells) te hi engtin nge a lo awm tih i hria em? Kan ruh chhunga ruhro (bone marrow)-a stem cell atanga siam an ni hmasa ber. Heng thisen sen (red blood cells) te hi zawi zawiin an lo thang lian a, kan thisen hi an zawm a, taksa peng leh tissue zawng zawngah oxygen an phur lut a ni.

Hetah hian thisen sen hrisel tak tak siam that nan hian nutrient pakhat folate an tih hi a pawimawh hle. Cement hmanga in sak ang mai a ni. Chuvangin, i taksain folate a hmuh tlem chuan i ruhro hian thisen sen pangngai a siam chhuak dawn lo. Chu ai chuan thisen sen chi khat, a pangngai lo tak, ``megaloblasts'' tih chu a siam chhuak zawk a ni.

Heng ``megaloblastic'' cell te hi an lian em em avangin thenkhat chu ruhro atang pawhin an chhuak lo va, thisen nen an inzawm lo. Cell inzawm tlat te hi thisen sen hrisel tak tak angin an dam rei lo. An thi thuai thin. Chuvang chuan taksaa thisen sen (red blood cells) a tlahniam a, thisen tlakchhamna (anemia) a thlen a, chu chu thisen tlakchham tihna a ni. I hrethiam em?

Anemia chi dang a awm em?

Ni e, thisen tlakchhamna hi mi tam takin an neih theih dan tlangpui a ni. Thisen sen (red blood cells) hrisel tak tak a awm loh vang a ni. Anemia hi a chhan hrang hrang a awm a:

• Thisen sen (red blood cells) lian tak tak (hei pawh hi kan sawi folate tlakchham vang pawh a ni).
• Thisen sen hrisel siam chhuah tlem.
• Liver leh spleen-in thisen sen (red blood cells) a tihchhiat lutuk.
• Thisen sen chhunga protein pakhat, oxygen phurtu hemoglobin level tlahniam.
• Hemoglobin a thawk tha lo tihna a ni a, oxygen a man tha thei lo tihna a ni.
• Thisen chhunga thisen sen (red blood cells) puak chhuak.

Thisen sen lian lo tak avanga thisen tlakchhamna pawl chu ``macrocytic anemia`` an ti a. Hei hi chi khat chu ``megaloblastic anemia`` a ni. A hnuaia mite hi he ``megaloblastic anemia`` hnuaiah hian an tla a ni:

• Folate tlakchhamna avanga thisen tlakchhamna
• Vitamin B12 tlakchhamna avanga thisen tlakchhamna
• Thisen tlakchhamna (pernicious anemia) a awm

Hei bakah hian thisen tlakchhamna chi dang, mi tam takin an hriat tawh chu:

• Iron tlakchhamna avanga thisen tlakchhamna
• Sickle cell atanga thisen tlakchhamna

Folate tlakchhamna hi engtiang chiahin nge a awm?

Folate tlakchhamna hi ram changkang zawkah chuan chutiang chuan a awm lo. Hei hi chu ram chhunga ei tur tam takah folate an dah tel vang a ni. Entirnan, United States-ah chuan kum 1998 atang khan ei tur ah folate dah tel ngei ngei tur a ni a, a chhan chu nausen nausen laia naupang thanlenna atan folate hi a pawimawh hle a ni.

Doctor-te chuan folate tlakchhamna hian piansualna thenkhat a thlen thei tih an hmuchhuak a, a bik takin neural tube defects, spina bifida ang chi te a thlen thei tih an hmuchhuak. Chuvang chuan ram tam takah chuan kan eitur tam takah folate hi kan dah tel a, a bik takin buhfai leh buhfai te hi a tel ve a ni.

Tute nge folate deficiency anemia vei theihna chance sang zawk?

Hetiang dinhmun hi vei tam zawk an awm. He category-ah hian i tel ve em tih en rawh:

• Nau neih kum tling hmeichhia: Folate mamawhna hi a bik takin naupai tum hmeichhia te, naupai lai te, leh nau hnute pek lai te tan a sang hle.
• Zu in tam lutuk te: Zu hian taksain nutrients a lakluh theihna a tichhe thin.
• Kum 60 chunglam mite.
• Economic lama harsatna nei te: Ei leh in inthlau tak lei a harsat avangin.
• Nu naupai leh nau hnute pe mek.

Folate tlakchhamna avanga thisen tlakchhamna hi eng nge ni?

A chhan ber chu kan ei leh in atanga folate kan hmuh tlem vang a ni. Chumi piah lamah chuan taksain folate a hip lut thei lo emaw, a hmang dik thei lo emaw chhan dang a awm bawk:

• Zu ruihhlo ngawlvei (`Zu hmansualna`).
• Kidney failure avanga dialysis enkawl mek.
• Digestive system natna, entirnan, Crohn natna leh celiac natna.
• Damdawi thenkhat hun rei tak hman (e.g., epilepsy, rheumatic disorder, antibiotics thenkhat, leh immunosuppressants te tan).
• Inherited conditions te chu ``Hereditary folate malabsorption`` (chutah chuan taksain folate a lakluh theihna a tihtlem phah thin).

Hei hi eng symptoms nge ni? Engtin nge i hriat chian?

A chang chuan folate tlakchhamna avanga thisen tlakchhamna (anemia) hi a awm thei a, a lan chhuah dan pawh a awm thei bawk. I doctor chuan thil dang thisen test i neih hunah chauh a hmu mai thei.

Mahse, natna lan chhuah dan a lo lan chuan hetiang hi a ni thei:

• Chau tih hriat reng (`chau`): Mut hnuah pawh hahna chu a reh lo ang mai a ni.
• Nitin hnathawh laiin rilru hah leh chak lo anga inhriatna.
• Luak chhuak, lu hahthlak tih hriat.
• Pale skin (`pallor`): Hmai, hmui, leh kutphah ang chi hmunte chu a sen hring angin a lang.
• I thinlung a thawk chak ang maia hriat te, i rilru chhunga thawm ri hriat emaw, i thinlungin a skip ang maia hriat te (heart palpitations).
• Thâwk harsa (dyspnea): Hna tê tê thawk pawha thawk hah.

Engtin nge he natna hi dik taka hriat theih a nih ?

Heng symptoms te hi i neih chuan doctor pan ngei ngei tur a ni. I doctor chuan taksa enfiahna a nei ang a, i medical history leh symptoms te a zawt ang. Folate tlakchhamna thisen tlakchhamna (symptoms) hi natna dang tam tak nen a inang avangin, hetiang hi a ni em tih hriat nan thisen test vawi tam tak neih a ngai mai thei.

Heng thisen test zinga a bulpui berte chu:

• Complete blood count (CBC): Hei hian thil tam tak a enfiah a, chu chu i thisenah thisen sen, thisen var, leh platelet awm zat te, hemoglobin awm zat te a enfiah thin.
• Peripheral blood smear (PBS): Hei hian i thisen sample lak a, microscope hmanga en a huam a ni. Hei hian thisen cell te hi eng ang chiah nge an nih tih chiang takin a hriat theih a, a lian emaw a te emaw, thil danglam bik a awm leh awm loh a hriat theih bawk.
• Reticulocyte count: Reticulocyte hi thisen sen naupang, puitling lo an ni. He test hian i ruhro hian thisen sen (red blood cells) a siam tling em tih a enfiah thin.

Heng test te bakah hian i doctor chuan i thisen folate level pawh a enfiah bawk ang. Hei hi `nanograms per milliliter` (`ng/mL`) an tih unit-a teh a ni tlangpui.

• A tlakchham: Milliliter khatah nanogram 2 aia tlem (`< 2 ng/mL`).
• Borderline: Milliliter khatah nanogram 2 leh 4 inkar (`2 ng/mL - 4 ng/mL`).
• A tawk: Milliliter khatah nanogram 4 aia tam (`> 4 ng/mL`).

Vitamin B12 tlakchhamna leh folate tlakchhamna hi a awm dun fo avangin doctor pawhin i vitamin B12 level a enfiah bawk ang.

Hei hi eng enkawlna nge ni?

Thu lawmawm tak chu, hei hi enkawlna a awm a, a hlawhtling hle.

Enkawlna ber chu vitamin B9 supplement pek hi a ni.Hengte hi ka ei tur pill angin pek a ni tlangpui. Mi thenkhat tan pill ei harsa tan chuan injection angin pek theih a ni bawk a, a nih loh leh thisenah (IV) saline nen pek theih a ni bawk. Heng supplement te hi thla engemaw zat chhung chu ei chhunzawm zel a ngai mai thei.

I doctor pawhin i ei leh in tihdanglam a rawt thei bawk. Folate tlakchhamna hi damdawi lam dinhmun hnuaia awm a nih chuan chu natna pawh enkawl a pawimawh hle.

Folate tlakchhamna thisen tlakchhamna hi ven theih a ni em?

Ni e, a theih ngei ang. Heng thilte hi i ngaihtuah chian chuan hetiang dinhmun hi pumpelh a awl hle:

• Nitin folate i ei tur zat chu i ei tur hmangin emaw, vitamin B9 (folic acid) awmna supplement ei hmangin emaw la rawh.
• Zu i in tam lutuk kha ti tlem la, a nih loh leh in kha bansan vek rawh. Zu in tam lutuk hian taksain ei tur pawimawh tak tak, folate te pawh a hip lut thei lo.
• I taksain folate a ei theih lohna tur emaw, a hman theih lohna tur damdawi lam harsatna i neih chuan i doctor nen sawiho rawh.

Ni khatah folate (vitamin B9) engzat nge kan mamawh?

Chaw atanga kan pianphung atanga vitamin B9 kan hmuh hi folate an ti a. Vitamin B9 ei tur a dah emaw, vitamin pill-a awm emaw chu folic acid an ti a. Ni khata folate kan mamawh zat hi thil engemaw zatah a innghat a:

• Kum: I upat deuh deuh chuan folate i mamawhna a sang chho zel a.
• Chaw lakna: Kan taksa hian chaw atanga folate aiin folic acid a hip tha zawk.

Recommended Daily Allowances (RDAs) hi microgram (mcg)-a tarlan a ni a, Dietary Folate Equivalents (DFE)-a teh a ni. Hei hi a buaithlak deuhin a lang thei a, mahse a awlsam hle.

• Chaw atanga folate `1 mcg` chu `1 mcg DFE` nen a inang a ni.
• Chaw eiah folic acid dah i hmuh emaw, ei tur nena ei vitamin pill atanga i hmuh emaw pawh nise, folic acid 1 mcg hi 1.67 mcg DFE nen a inang (taksa hian a hip tam zawk tihna a ni).
• Vitamin pill atanga folic acid 1 mcg chu pum ruak a ei chuan DFE 2 mcg (taksain a hip lut tha zawk) nen a inang a ni.

Entirnan, multivitamin `200 mcg` folic acid nen chaw ei khama i ei chuan `400 mcg DFE` (200 mcg x 2 = 400 mcg) anga chhut theih a ni.

Puitling pakhatin ni khatah DFE 400 mcg a mamawh a ni. Nu naupai chuan DFE 600 mcg an mamawh a, nau hnute pe mekte chuan DFE 500 mcg an mamawh bawk. I tan a zat tur dik tak doctor zawt la a tha ber.

Eng ei tur nge folate tamna?

Vanneihthlak takin folate awmna tha tak ei tur tam tak a awm a. I ei leh in ah hengte hi dah tel tum ang che:

• Sa: Bawnghnute liver (a tam hle a, mahse cholesterol chungchang pawh i ngaihtuah a ngai) .
• Thlai leh thlai chi hrang hrang: Greens te chu spinach, kale, collard greens, asparagus, Brussels sprouts, avocado, broccoli te ang chi te hi a ni.
• Fortified foods: Cereal thenkhat (breakfast cereals), buhfai, chhang, pasta, chhangphut chi, cornmeal. (Folic acid a tel leh tel loh hriat nan label en rawh.)
• Beans: Kal bean, kal bean.
• Nuts: Buh chi, walnut chi hrang hrang.
• Thei: Citrus thei chi hrang hrang orange leh tangerine leh a tui te.

Hriat reng tur: Heng chawte hi rei tak, tuiah chawhpawlh a nih chuan folate hi a chhe thei a ni. Chuvangin a tlem thei ang berin chhum la, a nih loh leh a raw (silfai tha) theih a nih chuan i chaw eiah telh bawk ang che.

He natna hi enkawl a nih chuan a dam leh dawn em?

A tam zawk chu a ni! Folate tlakchhamna thisen tlakchhamna enkawlna hi a hlawhtling hle tlangpui. Vitamin B9 supplement an ei tan atanga thla engemaw zat chhungin mi tam zawk chuan thisen sen hrisel tak tak an siam leh tan a, an natna lan chhuah dan pawh a reh zauh zauh thin.

Folate tlakchhamna avanga thisen tlakchhamna chungchangah engtikah nge doctor i biak ang?

Hetiang ang case-ah hian damdawi lam thurawn la ngei ang che:

• Ni khata folate i mamawh zat i hriat chian loh chuan, emaw, i ei tlem em tih i hriat chian loh chuan.
• Thisen tlakchhamna (chau, chak lohna, thawk hahna ang chi) i neih chuan.
• Folate tlakchhamna thlen thei damdawi dang i neih chuan.
• Tun hmain folate deficiency anemia i enkawl tawh a, i symptoms a lo let leh tawh ang tih i hriat chuan.
• Naupai i tum a nih chuan, emaw, naupai tawh i nih chuan. Hei hi a pawimawh hle mai!

I thisen cell-ah harsatna i nei tih hriat chu a buaithlak deuh thei. Mahse, symptoms hi i taksain thil dik lo a awm tih a hrilh dan che a ni tih hre reng ang che. Ei leh in inthlau tak i mamawh vang pawh a ni thei a, a nih loh leh damdawi lam dinhmun hnuaia awm a ni thei bawk. I doctor chuan a chhan zawng turin a thawkpui ang che. Tin, a tul chuan vitamin B9 supplement leh enkawlna dang an pe bawk ang. Enkawlna dik tak leh doctor thupek zawm chuan i natna lan chhuah dan chu a ṭhat phah ngei ang.

Hriat reng tur pawimawh ber berte (Take-Home Message) .

Okay, chuvangin kan sawi tawh atanga kan hriat reng tur thenkhat chu hetiang hi a ni:

• Folate (vitamin B9) hi thisen sen hrisel siamna atana ei tur pawimawh tak a ni.
• Folate tlakchhamna hian thisen sen lian tak tak, a pangngai lo (`megaloblasts`) a siam thei a, chu chuan thisen tlakchhamna a thlen thei a ni.
• Chauhna, chak lohna, vun dum, leh thawk harsa tih ang chi symptoms i neih chuan doctor pan rawh.
• Folate tamna ei tur (legumes, green vegetables, nuts, folate dah telna ei tur) te chu i eitur ah te dah tel bawk ang che.
• Naupai, nau hnute pe, leh nau pai tum hmeichhiate chuan folate lakah fimkhur hle tur a ni. Doctor-in a sawi angin folic acid pill ei thin ang che.
• Vawi tam tak chu he natna hi enkawlna hmangin a dam kim thei a ni.

Chuvangin, i taksa hi enkawl rawh. Ei leh in inthlau tak ei rawh. Harsatna i neih chuan Doctor biak pawh hlau suh. Hrisel taka awm hi a pawimawh ber!

` Folate, thisen tlakchhamna, vitamin B9, thisen tlakchham, thisen sen, ei leh in lama harsatna, naupai hriselna