Vitamin deficiency anemia results from low or depleted levels of vitamin B12 or folate (folic acid). Vitamin deficiency anemia usually develops slowly over several months to years. Deficiencies in these vitamins impair the body's ability to produce healthy red blood cells, leading to anemia characterized by symptoms like fatigue, weakness, pale skin, shortness of breath, and dizziness. Causes include inadequate dietary intake, malabsorption disorders, certain medical conditions, or medications. Treatment involves addressing the underlying deficiency through dietary changes, supplementation, or medical interventions, aiming to restore normal red blood cell production and alleviate symptoms of anemia.
Signs to note
Signs and symptoms may be subtle at first but usually increase as the deficiency worsens. These may include:
● Fatigue
● Shortness of breath
● Dizziness
● Pale or yellowish skin
● Arrhythmia
● Weight loss
● Numbness or tingling in the hands and feet
● Muscle weakness
● Personality changes
● Unsteady movements
● Mental confusion or forgetfulness.
What are the complications?
Being deficient in vitamin B-12 or folate increases your risk of many health problems, including:
● Pregnancy complications. Neural Tube Defects
● Nervous system disorders.
● Gastric cancer. Pernicious anemia increases the risk of stomach or intestinal cancers.
What causes vitamin B12 deficiency?
Low levels of vitamin B-12 can be caused by:
● Diet. Vitamin B-12 is mainly found in meat, eggs and milk, so diet lacking these, may need to take B-12 supplements. Some foods have been fortified with B-12, including some breakfast cereals and some nutritional yeast products.
● Pernicious anemia. Lack of intrinsic factor, B-12 can't be absorbed in the intestines.
● Gastric surgeries.
● Intestinal problems. Crohn's disease and celiac disease can interfere with absorption of vitamin B-12. Also can tapeworms that may be ingested from eating contaminated fish.
What are the causes of folate deficiencies?
Also known as vitamin B-9, folate is a nutrient found mainly in dark green leafy vegetables and liver. A folate deficiency can occur dietary deficiency or Absorption problems.
● Intestinal diseases such as celiac disease
● Surgical removal or bypass of a large part of the intestines
● Excessive alcohol consumption
● Prescription drugs, such as some anti-seizure medications
Diagnosis tests
Tests can be carried out to help identify people with a possible vitamin B12 or folate deficiency: CBC, Vitamin B12 levels, and folic acid levels.
Treatment
Good sources of vitamin B12 include:
meatsalmon and codmilk and other dairy productseggsVegetarian alternatives are foods that are fortified with vitamin B12, such as yeast extracts, breakfast cereals, and soy products.Good sources of folate include:broccolibrussels sproutsasparaguspeaschickpeasbrown rice
Drug management
In vitamin b12 deficiency:
● Initial: 30 mcg IM once daily for 5-10 days.
● Maintenance: 100-200 mcg IM monthly.
In Folic Acid deficiency
● Folate-deficient megaloblastic anemia due to dietary insufficiency or antiepileptic drugs: 5 mg/day for 4 months
● Malabsorption: Up to 15 mg/day for 4 months
● Chronic hemolytic states and kidney dialysis: for prophylaxis, 5 mg daily to weekly, depending on the patient's diet and rate of hemolysis
(Author: Dr Ajay Agarwal, Internal Medicine, Fortis Hospital, Noida)
