Vitamin b12 and folic acid deficiency anemia: symptoms, causes, drugs

Definition

What is B12 and folic acid deficiency anemia?

Vitamin B12 and folic acid (vitamin B9) deficiency anemia is anemia that occurs when your body doesn't have enough vitamin B12 and folic acid, resulting in erythroblasts (the forerunners of red blood cells) to burst or die (apoptosis). In other words, a deficiency of vitamin B12 and folic acid can cause anemia due to the incomplete process of red blood cell formation (erythropeiosis).

Red blood cells or erythrocytes play a role in delivering oxygen to body tissues through the circulatory system. Vitamin B12 and folate play an important role in the erythropoiesis process in which new and healthy red blood cells are produced to replace old red blood cells.

How common is this condition?

This type of anemia is very common and can affect patients at any age. This can be overcome by reducing your risk factors. Talk to your doctor for more information.

Signs and Symptoms

What are the symptoms of B12 and folic acid deficiency anemia?

Various types of anemia cause distinctive symptoms. Anemia related to vitamin B12 or folic acid deficiency can cause a variety of symptoms. This condition usually develops gradually at first and can worsen if the condition is not treated.

Vitamin B12 deficiency

If you have anemia caused by a vitamin B12 deficiency, you may have other symptoms besides those listed above, such as:

• Pale yellow on your skin
• Sore and red tongue (glossitis)
• Sprue
• Tingling sensation
• Changes in the way you walk and move
• Impaired eyesight
• Irritability
• Depression
• Changes in the way you think, feel and behave
• Decreased cognitive abilities, such as memory, understanding and judgment (dementia)

Some of these symptoms can also occur in people who have a vitamin B12 deficiency, but are not yet anemic.

Folate deficiency

Additional symptoms in people with anemia caused by folate deficiency can include:

• Numbness and tingling in the feet and hands
• Muscle weakness
• Depression

When should I see a doctor?

If you have any signs or symptoms above or any other questions, please consult your doctor. Everyone's body is different. Always consult a doctor to treat your health condition.

Cause

What causes the symptoms of B12 and folic acid deficiency anemia?

Different types of anemia are distinguished based on their cause. Lack of absorption of B12 and folic acid is the cause of anemia in this type.

Vitamin B12 deficiency anemia is also known as pernicious anemia. Apart from insufficient intake of vitamin B12, pernicious anemia is caused by an autoimmune condition that affects the absorption of vitamin B12 in the digestive system.

Vitamin B12 is absorbed into your body through the stomach. A protein called "intrinsic factor" will later bind to vitamin B12 to absorb it from your diet.

Quoted from the Mayo Clinic, pernicious anemia causes the immune system to attack cells in the stomach that produce intrinsic factor. As a result, the body is unable to absorb vitamin B12.

In addition, vitamin B12 deficiency anemia can also be caused by infections, surgery, drugs, or diet. This condition is more common in women who are around 60 years old, people with a family history of this condition and people with other autoimmune conditions, such as Addison's disease or vitiligo.

Quoted from the US Department of Health & Services website, the word "pernicious" from this type of anemia is taken from English absorption, namely pernicious which means bad or destructive. Pernicious anemia is called "devastating" because it was once thought to be fatal as a result of not providing adequate treatment.

Risk factors

What increases my risk for B12 and folic acid deficiency anemia?

The following are factors that can increase your risk of developing B12 and folic acid deficiency anemia:

1. Diet

Most people get their vitamin B12 from meat, fish, eggs, and dairy products. People who don't eat enough of these foods, such as vegetarians, are at risk of anemia related to vitamin deficiency. Alcohol can also interfere with the absorption of vitamin B12, making alcoholics another risk group.

2.Malabsorption (absorption problems)

Sometimes, your body may not be able to absorb folic acid as it should. This is usually caused by a digestive system disorder, such as Celiac disease or Crohn's disease.

Both diseases inhibit the body's ability to absorb vitamin B12. Older people may also have a condition called achlorhydria, in which the body doesn't produce enough stomach acid to release vitamin B12 in their diet for absorption by the intestines.

3. Excessive urination

You may lose folic acid from your body when you urinate too often. This can be caused by disturbances in your organs, such as:

• Congestive heart failure
• Acute liver damage
• Long term dialysis

4. Medicines

Some medications reduce the amount of folic acid in the body, or make folic acid more difficult to absorb. These drugs include several anticonvulsants (drugs used to treat epilepsy), cholestyramine, sulfasalazine and methotrexate.

Meanwhile, some medications can cause a reduction in the amount of vitamin B12 in your body. For example, proton pump inhibitors (PPIs) - drugs used to treat indigestion - can make vitamin B12 deficiency worse.

Complications

What are the possible complications caused by B12 and folic acid deficiency anemia?

Complications of anemia, regardless of cause, can include problems with the heart and lungs as these vital organs struggle harder. Meanwhile, anemia deficiency of B12 and folic acid may cause complications if not treated properly.

1. Nerve problems

Lack of vitamin B12 can cause neurological problems (which affect the nervous system), such as:

• Visual disturbances
• Memory loss
• Tingling sensation (paresthesia)
• Loss of physical coordination (ataxia), which can affect the performance of the whole body and cause difficulty speaking or walking
• Damage to the peripheral nervous system (peripheral neuropathy), especially on the feet

If neurological problems continue to develop, they may not be treatable.

2. Infertility

In some cases, vitamin B12 deficiency can cause temporary infertility (inability to get pregnant). This condition usually improves with proper vitamin B12 treatment.

As with vitamin B12 deficiency, folate deficiency can also affect your fertility levels. However, this is only temporary and can usually be treated with folate supplements.

3. Stomach cancer

If you develop a vitamin B12 deficiency caused by pernicious anemia (a condition in which your immune system attacks healthy cells in your stomach), your risk of stomach cancer increases.

Research shows that folate deficiency can increase the risk of some types of cancer, such as colon cancer.

4.Neural tube defects (neural tube defects)

Pregnant women who don't have enough vitamin B12 are at risk of having a baby with birth defects known as neural tube defects. The neural tube is the narrow channel that forms the brain and spinal cord.

Neural tube defects, including:

• Spina bifida, the baby's spine is not well developed
• Anencephaly, a baby born without parts of the brain and skull
• Encephalocele, a membrane or pouch of skin that contains part of the brain pushed out through a hole in the skull

As with vitamin B12 deficiency, folate deficiency can also affect the growth and development of the unborn baby in the womb (uterus). Lack of folate can increase the risk of neural tube defects, such as spina bifida, developing in an unborn baby.

5. Cardiovascular disease

Research shows that a lack of folate in the body can increase the risk of cardiovascular disease or cardiovascular disease (CVD).

CVD is a general term that describes heart or blood vessel disease, such as coronary heart disease (CHD).

6. Labor disorders

Lack of folate during pregnancy can increase the risk of your baby being born prematurely (before 37 weeks of gestation) or having low birth weight. The risk of placental abruption may also increase.

Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How to diagnose this condition?

Doctors diagnose anemia due to deficiency of vitamin B12 and folic acid by looking at the symptoms and paraclinical results. A blood test is an effective tool to confirm a case of vitamin B12 and folate deficiency anemia.

How to treat vitamin B12 and folic acid deficiency anemia?

Treat vitamin B12 deficiency anemia

To treat anemia due to deficiency of vitamin B12 and folic acid, patients are usually given injections or supplement tablets to replace the lost vitamins.

Vitamin B12 supplements are usually given by injection first. Your doctor will then consider your condition and can provide other treatments for you. You may need to take extra vitamin B12 tablets between meals, injections or to improve your diet.

Treat folic acid deficiency anemia

Folic acid tablets can be used to restore folate levels. Treatment usually lasts 4 months.

A balanced diet is also an effective treatment and prevention for this condition.

Home remedies

What are the lifestyle changes or home remedies that can be done for this condition

Lifestyle improvements can help you prevent anemia. Here are lifestyle and home remedies that can help you treat and prevent vitamin B12 and folate deficiency anemia.

• Have a healthy diet that contains a variety of foods and nutrients.
• Foods rich in folate include dark green leafy vegetables, legumes, fortified grain products, such as bread, cereals, pasta, and rice, as well as fruit and fruit juices.
• Foods rich in vitamin B12 include eggs, fortified foods, such as cereal, milk, cheese and yogurt, as well as red and white meats, shellfish.

If you have any questions, consult your doctor for the best solution to your problem.