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With a Grade C, they state that “nutritional anemias resulting from malabsorptive bariatric surgical procedures can involve deficiencies in vitamin B12, folate, protein, copper, selenium, and zinc and may be evaluated when routine aggressive case finding for iron-deficiency anemia is negative.” Additionally, findings of folate deficiency in patients with obesity prior to bariatric surgery by the ASMBS “justifies aggressive case finding preoperatively with biochemical testing, specifically using sensitive markers, such as red-blood-cell folate and homocysteine (methylmalonic acid is normal with folate deficiency and normal B12 status)” and they note that particular attention should be given to individuals of childbearing age

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85 A randomized controlled trial in 769 infertile men with low sperm numbers and MTHFR polymorphisms found, in those with the MTHFR 677 TT genotype, 800 mcg (1,360 mcg DFE) folic acid daily for three months improved semen parameters and sperm fragmentation

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