In the GI tract this can lead to atrophy of the luminal lining and further malabsorption. As discussed further below, only vitamin B 12 deficiency leads to neurological damage. The mechanism is unknown. Oral contraceptive and anticonvulsants lead to increase consumption of folate. Alcohol - Alcohol affects several aspects of folate metabolism.
Alcoholics have poor intake of folate.
In addition, folate metabolism is interfered with leading to a functional folate deficiency. Alcoholics have an inability to mobilize folate stores and can have depleted tissue stores with normal serum levels of folate. Abnormal gastric events include being unable to dissociated vitamin B 12 from food due to lack of stomach acid or enzymes. This is a recently recognized group of patients which may compose a very large subset of patients with vitamin B 12 deficiency. Abnormal mucosal events including malabsorption syndromes and surgical removal of the terminal ileum.