What vitamin deficiency can be caused by methotrexate?

Methotrexate is a medication commonly used in the treatment of various conditions, including certain cancers and autoimmune diseases. One of its primary mechanisms is the inhibition of dihydrofolate reductase, an enzyme crucial for the synthesis of folate. This inhibition prevents the proper conversion of dihydrofolate to tetrahydrofolate, thereby interfering with folate metabolism.

Folate is essential for DNA synthesis, repair, and methylation as well as for the production of red and white blood cells. A deficiency in folate can lead to various health issues, including megaloblastic anemia and, in some cases, increased toxicity in patients concurrently taking methotrexate. Because of these effects, patients on methotrexate are often advised to take folic acid supplements to mitigate this deficiency.

The other vitamins listed do not have a direct association with methotrexate use. Vitamin B12 deficiency may occur due to various nutritional factors but is not specifically linked to methotrexate. Vitamin D and Vitamin C deficiencies arise from different dietary or lifestyle factors unrelated to the mechanism of methotrexate. Thus, the specific impact of methotrexate on folate metabolism makes it clear that folate deficiency is the relevant concern in