Vitamin B12 or folate deficiency anaemia
Vitamin B12 or B9 (commonly called folate) deficiency anaemia occurswhen a lack of vitamin B12 or folate causes the body to produce abnormally large red blood cells that can't function properly.
Red blood cells carry oxygen around the body using a substance called haemoglobin.
Anaemia is the general termfor having either fewer red blood cells than normal or having an abnormally low amount of haemoglobin in each red blood cell.
There are several different types of anaemia, and each one has a different cause. For example, Iron deficiency anaemia , which occurswhen the body doesn't contain enough iron.
Vitamin B12 and folate perform several important functions in the body, including keeping the nervous system healthy.
A deficiency in either of these vitamins can cause a wide range of problems, including:
Some of these problems can also occur if you have a deficiency in vitamin B12 or folate, but don't have anaemia.
Read about the symptoms of vitamin B12 or folate deficiency anaemia .
See your GP if you think you may have a vitamin B12 or folate deficiency. These conditions can often be diagnosed based on your symptoms and the results of a blood test .
It's important for vitamin B12 or folate deficiency anaemia to be diagnosed and treated as soon as possible because, although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible.
Read about diagnosing vitamin B12 or folate deficiency anaemia .
There are a number of problems that can lead to a vitamin B12 or folate deficiency, including:
Both vitamin B12 deficiency and folate deficiency are more common in older people, affecting around 1 in 10 people aged 75 or over, and 1 in 20 people aged 65 to 74.
Read about the causes of vitamin B12 or folate deficiency anaemia .
Most cases of vitamin B12 and folate deficiency can beeasily treated with injections or tablets to replace themissing vitamins.
Vitamin B12 supplements are usually given by injection at first. Then, depending on whether your B12 deficiency is related to your diet, you'll either require B12 tablets between mealsor regular injections. These treatments may be needed for the rest of your life.
Folic acid tablets are used to restore folate levels. These usually need to be taken for four months.
In some cases, improving your diet can help treat the condition and prevent it recurring. Vitamin B12 is found in meat, fish, eggs,dairy products, yeast extract (such as Marmite) and specially fortified foods. The best sources of folate include green vegetables such as broccoli, Brussels sprouts and peas.
Read about treating vitamin B12 or folate deficiency .
Although it's uncommon, vitamin B12 or folate deficiency (with or without anaemia) can lead to complications, particularly if you've been deficient in vitamin B12 or folate for some time.
Potential complications can include:
Adults with severe anaemia are also at risk of developing heart failure.
Somecomplications improve with appropriate treatment, but others such as problems with the nervous system can be permanent.
Read about the complications of vitamin B12 or folate deficiency anaemia .
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.