Vitamin B12 or Folate Deficiency Anaemia

Vitamin B12 or folate deficiency anaemia is a type of anaemia that occurs when the body does not have enough vitamin B12 or folate to produce healthy red blood cells.

Causes

• Poor diet: A lack of vitamin B12 or folate in the diet can lead to deficiency.
• Pernicious anaemia: An autoimmune disorder that causes the body to attack the cells in the stomach that produce intrinsic factor, a protein needed to absorb vitamin B12.
• Gastrointestinal disorders: Conditions such as celiac disease, Crohn's disease, and ulcerative colitis can affect the absorption of vitamin B12 and folate.
• Medications: Certain medications, such as proton pump inhibitors and histamine-2 (H2) blockers, can interfere with the absorption of vitamin B12.
• Aging: The ability to absorb vitamin B12 decreases with age.

Symptoms

• Fatigue and weakness
• Shortness of breath
• Dizziness or lightheadedness
• Pale skin
• Headaches
• Diarrhoea or constipation
• Loss of appetite
• Weight loss
• Numbness or tingling in the hands and feet
• Difficulty walking

Diagnosis

Diagnosis is typically made through a combination of physical examination, medical history, and laboratory tests, including:

• Full blood count (FBC): To check for low red blood cell count and other abnormalities.
• Vitamin B12 and folate levels: To check for deficiency.
• Reticulocyte count: To check for the production of new red blood cells.
• Peripheral smear: To examine the shape and size of red blood cells.

Treatment

Treatment depends on the underlying cause of the deficiency, but may include:

• Vitamin B12 injections or supplements: To replace deficient vitamin B12.
• Folate supplements: To replace deficient folate.
• Dietary changes: To increase intake of foods rich in vitamin B12 and folate, such as meat, fish, poultry, and fortified cereals.
• Treatment of underlying conditions: Such as pernicious anaemia or gastrointestinal disorders.

Complications

If left untreated, vitamin B12 or folate deficiency anaemia can lead to:

• Persistent fatigue and weakness
• Nerve damage: Causing numbness, tingling, and difficulty walking.
• Cognitive impairment: Affecting memory, concentration, and mood.
• Pregnancy complications: Such as miscarriage, stillbirth, and birth defects.

Prevention

To prevent vitamin B12 or folate deficiency anaemia:

• Eat a balanced diet that includes foods rich in vitamin B12 and folate.
• Consider supplements if you are at risk of deficiency, such as vegetarians or vegans.
• Get regular check-ups with your doctor to monitor your vitamin B12 and folate levels.