The treatment for vitamin B12 or folate deficiency anaemia depends on what's causing the condition. Mostpeople can be easily treated withinjections or tablets to replace the missing vitamins.

Treating vitamin B12 deficiency anaemia

Vitamin B12 deficiency anaemia is usually treated with injections of vitamin B12, in a form called hydroxocobalamin.

At first, you'll have these injections every other day for two weeks, or until your symptoms have stopped improving. Your GP or nurse will give the injections.

After this initialperiod, yourtreatment will depend on whether the cause of your vitamin B12 deficiency is related to your diet. The most common cause of vitamin B12 deficiency in the UK is pernicious anaemia, which isn't related to your diet.

Alternatively, you may need to have an injection of hydroxocobalamin twice a year.

People who find it difficult to get enough vitamin B12 in their diets, such asthose following a vegan diet, may need vitamin B12 tablets for life.

Although it's less common, peoplewith vitamin B12 deficiency caused by a prolonged poor diet may be advisedto stop taking the tablets once their vitamin B12 levels have returned to normal andtheir diet has improved.

Good sources of vitamin B12 include:

  • meat
  • salmon and cod
  • milk and other dairy products
  • eggs

If you're a vegetarian or vegan, orare looking for alternatives to meat and dairy products, there are other foods that contain vitamin B12, such as yeast extract (including Marmite), as well as some fortified breakfast cereals and soy products.

Check the nutrition labels while food shopping to see how much vitamin B12different foods contain.

Not diet-related

If your vitamin B12 deficiency isn't caused by a lack of vitamin B12 in your diet, you'll usually need to have an injection of hydroxocobalamin every three months for the rest of your life.

If you've had neurological symptoms (symptoms that affect your nervous system, such as numbnessor tingling in your hands and feet) caused by a vitamin B12 deficiency, you'll be referred to a haematologist, and you may need to have injections every two months. Your haematologist will adviseonhow long you need to keep taking the injections.

Forinjections of vitamin B12 given in the UK, hydroxocobalamin is preferred to an alternative called cyanocobalamin. This is because hydroxocobalamin stays in the body for longer.

If you need regular injections of vitamin B12, cyanocobalaminwould need to be given once a month, whereas hydroxocobalamin can be given every three months.

Cyanocobalamin injections aren't routinely available on the NHS. However, if you need replacement tablets of vitamin B12, these will be cyanocobalamin.

Treating folate deficiency anaemia

To treat folate deficiency anaemia, your GP will usually prescribe daily folic acid tablets to build up your folate levels. They may also give youdietary advice so you can increase your folate intake.

Good sources of folate include:

  • broccoli
  • Brussels sprouts
  • asparagus
  • peas
  • chickpeas
  • brown rice

Most people need to take folic acid tablets for about four months. However, if the underlying cause of your folate deficiency anaemia continues, you may have to take folic acid tablets for longerpossibly for life.

Before you start taking folic acid, your GP will check your vitamin B12 levels to make sure they're normal. This is because folic acid treatment can sometimes improve your symptoms so much that it masks an underlying vitamin B12 deficiency.

If a vitamin B12 deficiency isn't detected and treated, it could affect your nervous system.

Monitoring your condition

To ensure your treatment is working, you may need to have furtherblood tests.

Ablood test is often carried out around 10-14 days after starting treatment to assess whether treatment is working. Thisis to check your haemoglobin level and the number of the immature red blood cells (reticulocytes) in your blood.

Another blood test may also be carried out after approximately eight weeks to confirm your treatment has been successful.

If you've been taking folic acid tablets, you may be tested again once the treatment has finished (usually after four months).

Most people who have had a vitamin B12 or folate deficiency won't need further monitoring unless their symptoms return, or their treatment is ineffective. If your GP feelsit's necessary, you may have to return for an annual blood test to see whether your condition has returned.

Content supplied by the NHS Website

Medically Reviewed by a doctor on 9 Jan 2017