Vitamin B12 or folate deficiency anaemia
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.
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:
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.
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.
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:
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 longer possibly 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.
To ensure your treatment is working, you may need to have further Blood 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.
Anemia caused by vitamin B12 deficiency (or folate deficiency anemia) is caused by the production of unusually large, structurally abnormal, immature red blood cells. As a result of this enlargement, the body begins to produce a smaller number of red blood cells. In this way, the red blood cells cannot effectively perform all of their usual functions. This condition is also termed megaloblastic anemia. Patients feel extremely tired, seem to have lost most of their energy, exhibit a sore, reddened tongue, muscular weakness, ulcers in the mucosa of the mouth, visual disruptions, mental issues, etc.
Megaloblastic anemia exhibits severe symptoms, especially when it becomes severe. Symptoms include: feeling extreme fatigue, lethargy, headaches, difficulties in breathing, tachycardia (palpitations), loss of appetite, yellowing skin. WIth the progression of the disease, the symptoms become increasingly aggravated and increase in number. These aggravated symptoms include: a reddening of the tongue, the tongue becomes covered in plaques, a change in the manner of walking, numbness of the muscles, ulcers in the mouth, visual problems, overall mood disorders (aggravation and depression), the manner in which the patient thinks and their memory becomes compromised, etc.
The lack of vitamin B12 in the body may cause megaloblastic anemia. This type of anemia may occur due to: 1. PERNICIOUS ANEMIA: Pernicious anemia is an autoimmune condition. In this case the immune system becomes compromised, and instead of defending the body from foreign pathogens and other infections, it attacks healthy cells in the body. Pernicious anemia is a condition which involves a defect in the stomach. In the stomach, vitamin B12 is combined to a protein called intrinsic factor. Intrinsic factor protein is crucial for the absorption of vitamin B12 in the small intestine (jejunum); without it vitamin B12 cannot be absorbed. Pernicious anemia occurs when the immune system begins to attack the healthy stomach cells which produce intrinsic factor, hence the absorption of vitamin B12 is rendered impossible. 2.DIET: Many individuals suffer from megaloblastic anemia as a result of consuming foods with insufficient amounts of vitamin B12. 3.STOMACH SURGERY: When the part of the stomach that produces intrinsic factor protein is surgically removed, the absorption of vitamin B12 is impaired. 4. MEDICATION: Using proton pump inhibitors (H2 antagonists). 5. Functional deficit of vitamin B12.
In order to diagnose anemia due to vitamin B12 deficiency, several blood tests are necessary: 1. Assessing the levels of haemoglobin in the blood. 2. Assessing the levels of erythrocytes in the blood as well as their shape. 3. Levels of B12 in the blood. 4. Assessing the levels of folates in the blood. The creation of a haemogram which includes the entire leukocyte formula, which aids a haematologist in the determination of the diagnosis. There are several indicators present in a haemogram which aid physicians in determining a diagnosis. Patients suffering from anemia usually exhibit low haemoglobin, lowered levels of erythrocytes and enlarged erythrocytes, erythrocytic volume of above 120. Leukocytes are usually lowered. Patients are referred to haematologists if the problem if haematological. If the anemia is caused by a lack of absorption in the digestive tract, a gastroenterologist. If the anemia is caused by a lack of vitamin B12 in the diet, a nutritional specialist, etc.
In order to treat megaloblastic anemia, the causes of the of the vitamin B12 deficiency must be known. The treatment is via injection or tablets to correct the deficiency. Vitamin B12 cyancobalamin or hydroxybalamin is often administered via an intramuscular injection, dosage from 100 up to 1000 gamma. Hydroxybalamin is preferred more so than cyancobalamin, because it lasts longer in the organism. is This type of therapy is used every day, or one ampoule per day depending on the condition of the patient. Patients are recommended to adjust their diet in order to consume foods that are rich in vitamin B12, such as foods rich in protein, like red meat, salmon, milk, cheese, yoghurt, butter, eggs etc. If it is the pernicious anemia causing the condition, the physician will recommend a detailed course of treatment. In this case, medication should be used for the remainder of the patient's life, in monitored doses. If the condition is caused by medication which lower the absorption of vitamin B12, the responsible medication is interrupted or substituted. If the condition is caused by a folate deficiency, folic acid in 5 mg tablets is used, 2 to 3 times a day. Green vegetables and foods high in folate content are recommended, such as peas, broccoli, chickpeas, brussel sprouts, asparagus, rice, coffee, etc. Many individuals need to take folic acid for several months. After taking the medicine for 10 to 15 days, blood tests are taken in order to monitor the levels of haemoglobin, the number of red blood cells or a complete haemogram in order to continue medication.
If megaloblastic anemia is medicated well and on time, complications are rare. If the anemia remains unmedicated, or badly medicated, the anemia may become prolonged and the following complications may occur: 1. HEART RHYTHM DISRUPTIONS (TACHYCARDIA) OR DISRUPTIONS OF BLOOD PRESSURE. 2. NEUROLOGICAL PROBLEMS: Lowered memory capabilities, visual disruptions, bad coordination in speech and movement, muscular cramps, peripheral neuropathy, etc. 3. INFERTILITY 4. STOMACH CANCER When the anemia due to vitamin B12 deficiency is caused by pernicious anemia, there is a risk of developing stomach cancer. 5. GIVING BIRTH TO BABIES WITH CONGENITAL DEFECTS 6. COLON CANCER 7. CARDIOVASCULAR DISEASE 8. PREMATURE BIRTH, ETC.