What is Vitamin B12 and Folate Deficiency Anemia?
Vitamin B12 Or Folate Deficiency Anemia is a condition that develops when the body lacks vitamin B12 or folate. This causes the body to produce red blood cells that do not function properly. This type of anemia can occur when your body has trouble absorbing or processing vitamin B12.
The main symptoms of vitamin B12 or folate deficiency anemia have in the form of tiredness and tiredness. If you feel tired and tired continuously, you should consult a doctor. Based on your symptoms and blood test results, your doctor can give you a diagnosis of anemia.
People with Vitamin B12 or Folate Deficiency Anemia
Vitamin B12 deficiency is rare in young people, although those who follow a strict vegetarian diet can be at risk of suffering from the condition. Deficiency of vitamin B12 or folate is more common in the elderly with an estimated rate of 1 in 10 people over the age of 75 years. The most common impact of vitamin B12 deficiency is pernicious anemia.
Types of Anemia Suffered
There are many different types of anemia and each has its own causes. On this occasion, the theme discussed focused on anemia caused by a lack of vitamin B12 or folate in the body.
Due to Vitamin B12 or Folate Deficiency
To help the body produce red blood cells, it takes the cooperation of vitamin B12 or folate. Vitamin B12 is also useful to help keep the nervous system healthy. This includes the brain, nerves, and spinal cord. On the other hand, folate is also very important for pregnant women. Because folate deficiency can increase the risk of congenital abnormalities or birth defects in the unborn baby.
Vitamin B12 can be found in meat, eggs, and dairy products. While the best sources of folate are contained in green vegetables such as broccoli, Brussels sprouts, and peas.
Ways to treat Vitamin B12 and folate deficiency anemia
Vitamin B12 and folic acid deficiency anemias are mostly easy to treat. Treatment of this type of anemia, initially will be given vitamin B12 by injection. Depending on whether your B12 deficiency is related to your diet or not, you may need to take supplement tablets between meals. Or it could also regularly do injections of vitamin B12. This treatment may be needed for life.
To restore the level of folic acid, folic acid tablets are needed and these tablets must be taken for four months to reach normal levels in the body. Deficiency of vitamin B12 or folate, with or without anemia, can lead to complications although they are rare. For example, problems with the heart, lungs, and nervous system and increase the risk of infertility. However, all complications are generally treatable.
Symptoms of Vitamin B12 and Folate Deficiency Anemia
The symptoms of each type of anemia largely depend on the underlying cause of the condition. For any type of anemia, they all share some of the same general symptoms. The symptoms in question are:
- Fatigue
- Easy to faint
- Weight loss
- Shortness of breath or dyspnea
- Headache
- Loss of appetite
- Tinnitus or the perception of hearing sounds coming from within the body, not from outside
Symptoms of Vitamin B12 Deficiency Anemia
The symptoms below are specifically caused by anemia due to vitamin B12 deficiency. Symptoms include:
- Red and sore tongue or inflammation of the tongue
- Skin color becomes yellowish
- Thrush in the mouth
- The sense of touch feels different or its function is reduced
- Decreased ability to feel pain
- Impaired vision
- Easy to get angry
- Changes in the way you walk and move
- Depression: Feeling very sad and lasts a long time
- Dementia: Decreased mental abilities, such as memory, comprehension and judgment
- Psychosis: A condition that affects the mind and changes patterns of thinking, feeling, and behavior
Symptoms of Folate Deficiency Anemia
Symptoms of folate deficiency are similar to the common symptoms of anemia. But this condition can also cause decreased sense of touch, for example reduced or lost sense of touch and pain. And also the ability of the muscles to weaken and feel depressed.
Causes of Vitamin B12 and Folate Deficiency Anemia
There are various types of anemia and each has its own cause. Vitamin B12 or folate deficiency anemia can be caused by many things. This condition can affect the body's ability to produce healthy and functioning red blood cells.
The following will explain the function of a clear liquid in the blood called plasma. This fluid contains three different types of cells.
- White blood cells are part of the immune system and fight infection
- Red blood cells to carry oxygen throughout the body with a substance called hemoglobin
- Platelets to help blood to clot
Causes of Vitamin B12 Deficiency Anemia
Suffering from pernicious anemia
The body absorbs vitamin B12 through the stomach. In order for vitamin B12 to be absorbed from the food you eat, a protein called intrinsic factor attaches itself to vitamin B12.
Pernicious anemia is an autoimmune disease that affects the stomach. Autoimmune disease means your immune system attacks your body's own healthy cells. In pernicious anemia, your body's own immune system attacks the cells in the stomach that produce intrinsic factor. Deficiency occurs because the body cannot absorb vitamin B12.
There are several things that increase your risk of developing pernicious anemia. Although the main cause is unknown, the following are some things that can increase the risk:
- Pernicious anemia affects women more than men.
- Pernicious anemia is more common in people over 60 years of age.
- Nearly a third of people with pernicious anemia come from families with the same disease.
- Have other autoimmune diseases such as Addison's disease and vitiligo. In fact, there is a link between pernicious anemia and other immune diseases.
Factors of food consumed
Meat, fish, and dairy products are foods that provide enough vitamin B12. Vegetarians or people who eat only plant foods, may not have enough vitamin B12 in their diet. Or people who have had very simple menus over a long period of time.
The body normally stores vitamin B12 which lasts for two to four years. To keep these vitamin stores at healthy levels, it is very important to have vitamin B12 in your diet.
Diseases that affect the intestines
When the body can't absorb vitamin B12 as it normally would, it may be due to a disease that affects the intestines or parts of the digestive system. For example, Crohn's disease. It is a long-term disease that causes inflammation of the digestive system. This condition can make your body deficient in vitamin B12.
Diseases that affect the stomach
The inhibition of the process of absorption of vitamin B12 can be caused by the condition of the stomach or the working process of the stomach. For example, the risk of getting vitamin B12 deficiency anemia increases due to a gastrectomy or surgical procedure in which part of the stomach is removed.
Due to the consumption of certain drugs
Vitamin B12 can be reduced from the body due to the consumption of several types of drugs. For example, proton pump inhibitors (PPIs), which are medications to treat digestive problems, can make vitamin B12 deficiency worse. PPIs prevent excess stomach acid from being made. Stomach acid is what is needed to release vitamin B12 from the food you eat. Your doctor can identify if any medications have an impact on your vitamin B12 levels.
Folate Deficiency Anemia
Folate is a water-soluble vitamin. Therefore the body will not be able to store folate in the long term. Normally the body stores enough folate to last for four months. To ensure that the body has sufficient folate reserves, we must get folate from our daily diet. Folate deficiency anemia can develop for some of the same reasons as vitamin B12 deficiency anemia. Some of the causes are described below.
Food consumed
Some people may not get folate in their daily life. Some of the factors that may be the cause is an unhealthy and unbalanced diet. In addition, they may have recently changed the type or pattern of daily food, for example for reasons of losing weight
The occurrence of malabsorption
If you have Celiac disease, this condition can affect your digestive system. As a result, the body cannot absorb folate effectively.
Excessive urination
People with kidney and liver disease may lose folate from the body. This is because the effects of the disease make you urinate excessively. Some things that can make you urinate excessively:
- Congestive heart failure occurs when the heart is unable to pump enough blood throughout the body
- Acute liver damage. Often this is caused by consuming too much liquor in excess
- Long-term dialysis: the dialysis machine filters waste products from the blood
Due to the consumption of certain drugs
Folate is sometimes difficult to absorb and the amount of folate is reduced. This may be due to some of the effects of the drugs. The doctor will monitor you if necessary. Your doctor will be aware of medications that can affect the level of folate in your body.
Some other causes
Premature babies born before 37 weeks of gestation are more likely to develop folate deficiency anemia because their developing bodies cannot meet the needs of the vitamin folate.
Folate deficiency can occur because the body cannot meet the needs of the vitamin because sometimes the body needs folate beyond its normal level. Things that make the body need more folate:
- Suffering from cancer
- When pregnant
- Fights infections or health conditions that cause inflammation or swelling
- Have a blood disorder, such as sickle cell anemia. This is an inherited disorder that causes red blood cells to change shape
Pregnancy factor
If you are pregnant or planning to become pregnant, it is recommended to take a folic acid supplement of 0.4 mg per day. This is done until the pregnancy is 12 weeks. This will help your baby grow and develop, as well as ensure that you and your baby have enough folate in your body.
If you are pregnant with certain conditions, your body may need additional folic acid. To prevent anemia from occurring, the doctor will monitor carefully. You can buy folic acid tablets straight away or get a prescription from your doctor and take them to a pharmacy, large supermarket, or health food store. For people with diabetes, you may need higher doses of folic acid. You should consume folic acid as much as 5 mg per day.
Diagnosis of Vitamin B12 and Folate Deficiency Anemia
Based on the symptoms experienced and the results of blood tests, a diagnosis of vitamin B12 or folate deficiency anemia can be confirmed. To measure different types of blood cells from a sample, it is necessary to perform a full blood count. In general, the doctor will check:
- Is the size of red blood cells more than normal?
- Is the hemoglobin level too low
- How much vitamin B12 is in the blood
- How much folate is in the blood
To determine the type of anemia you have, test results will show whether you are deficient in vitamin B12 or folate. To determine the underlying cause of the deficiency and determine the most appropriate treatment, further testing is necessary. To find out more clearly the cause of anemia, you may be referred to a specialist.
See a digestive system specialist
You are referred to a digestive system specialist if there is a suspicion that your digestive system is not absorbing food nutrients properly. If so the composition of vitamin B12 or folate in the body has been reduced.
See a hematologist
A hematologist is a doctor who specializes in blood diseases. If you are pregnant and have vitamin B12 or folate deficiency anemia, it is recommended that you see a hematologist.
If the nervous system such as the brain and spinal cord has been affected, you will be advised to see a hematologist. Symptoms that may occur are changes in vision, a reduced or altered sense of touch, and an inability to control muscles.
Consultation with a nutritionist
Nutritious food menus can be suggested by nutritionists. They are medical professionals who are experts in nutrition. If the diet is not healthy, it can lead to vitamin B12 or folate deficiency. You may be advised to see a nutritionist. To increase the amount of vitamin B12 or folate in the diet, nutritionists can make a more appropriate diet for us.
Treatment of Vitamin B12 and Folate Deficiency Anemia
Treatment for vitamin B12 or folate deficiency anemia depends on what is causing the condition. In most attempts to replace vitamins for the body, treatment can be done with injections or vitamin B12 tablets.
Treating Vitamin B12 Deficiency Anemia
Vitamin B12 injections are given to treat vitamin B12 deficiency anemia in the form of hydroxocobalamin. Every day for the first two weeks, you will get this injection, until the symptoms stop. Injections can be done by a doctor or nurse.
Treatment depends on the cause of the vitamin B12 deficiency. Whether related to food or not, after the initial treatment above.
Food-associated vitamin B12 deficiency anemia
Prescription vitamin B12 tablets are given to be taken daily after meals. This is done if the vitamin B12 deficiency is caused by a lack of the vitamin in the diet. Or maybe you are injected with hydrococobalamin twice a year. For perpetrators of a vegetarian lifestyle, it will be difficult to get vitamin B12 in their diet. In this condition, you may have to take vitamin B12 tablets for the rest of your life.
For those who lack vitamin B12 due to a poor diet in the long term, vitamin B12 consumption can be stopped if the content in the body is normal and the food menu has been changed.
Good sources of vitamin B12 are meat, eggs, salmon, cod and dairy products, including milk itself. For vegetarians or vegans, there are substitutes for meat and dairy products. Foods that contain vitamin B12, such as iron-rich breakfast cereals and soy products. When shopping for food, check the nutrition table to see how much vitamin B12 there is.
Non-food related vitamin B12 deficiency anemia
For vitamin B12 deficiency that is not caused by a poor diet, you may need four times a year hydroxocobalamin injections for life. There is another type of injectable vitamin called cyanocobalamin, but people prefer hydroxocobalamin because it lasts longer in the human body. Cyanocobalamin is also available in tablet form.
If you need regular injections of vitamin B12, hydroxocobalamin can be injected every three months, while cyanocobalamin should be given once a month.
Blood specialists can be recommended as a treatment step when vitamin B12 deficiency causes symptoms of neurological disease. For example, the feet and hands often feel stiff or tingling. You may also need vitamin B12 injections every two months. Specialists can advise how long you need to take vitamin injections.
Treating Folate Deficiency Anemia
The doctor will prescribe folic acid tablets to increase the level of folate in the body. Folic acid tablets need to be taken for four months. But you can also take folic acid tablets for much longer, even for life, if the underlying cause of folate deficiency anemia doesn't go away.
In addition to increasing folate intake, your daily diet must also be considered. Good sources of folate include:
- Brown rice
- Brussels sprouts
- Broccoli
- Asparagus
- Peas
- Chickpeas
Before starting to take folic acid, the level of vitamin B12 will be checked whether it is within normal limits. This test is necessary because folic acid can worsen the symptoms experienced from vitamin B12 deficiency anemia. The nervous system will be affected if vitamin B12 deficiency is not detected and not treated immediately.
Monitoring Conditions During Treatment
Follow-up blood tests will need to be done to make sure the treatment is working. The hemoglobin level will be checked through a blood test to see if it has risen 10 days after starting treatment. To ensure the treatment was successful, a further blood test was performed 2 months later.
The test will be done again at four months after the completion of treatment if you are taking folic acid tablets. Unless symptoms previously reappeared or treatment was ineffective. Most people with vitamin B12 or folate deficiency do not need constant monitoring. To see if your condition has recovered or if the doctor feels it is necessary, a blood test will be done again.
Complications of Vitamin B12 and Folate Deficiency Anemia
Complications are rare in most cases of vitamin B12 deficiency or folate deficiency, but if you have a long-term vitamin B12 or folate deficiency, complications can occur.
Complications Caused by Anemia
Regardless of the cause, anemia can lead to heart and lung complications as the heart tries harder to pump oxygen to other organs.
Diseases that can develop in people with anemia are tachycardia or a heart rate of more than 100 beats per minute. It can also occur heart failure or when the heart does not pump blood throughout the body properly.
Complications Caused by Vitamin B12 Deficiency
Complications that occur below are caused due to vitamin B12 deficiency with or without anemia.
Problems with fertility
Sometimes a vitamin B12 deficiency can cause temporary infertility.
Disorders of the nervous system
Nervous systems such as the brain and spinal cord can be affected due to vitamin B12 deficiency. Vitamin B12 is important for the production of red blood cells, as well as for the health of the nervous system. Without proper treatment, complications of vitamin B12 deficiency can become permanent. Vitamin B12 deficiency can lead to other health problems before eventually becoming anemia. The following are things that may be experienced:
- Memory loss
- Problems with vision
- Ataxia: loss of physical coordination, this can affect the whole body and can cause difficulty speaking or walking
- Paresthesias: tingling sensation
The appearance of neural tube defects (NTD)
The risk of the baby having congenital abnormalities (NTD) will increase if during pregnancy, the mother lacks vitamin B12 in her body. The growth and development of the baby is affected by this disorder. Some examples of abnormalities that occur are spina bifida, namely, the baby's spine is not formed properly. In addition, anencephaly can occur or the baby's brain and cranium are not fully formed.
Complications Caused by Folate Deficiency
Complications can be caused by folate deficiency with or without anemia. Some of the complications are described below.
Problems with fertility
Just like vitamin B12 deficiency, fertility can also be affected due to folate deficiency, but the impact can be overcome by taking vitamin supplements and is only temporary.
The appearance of neural tube defects (NTD)
The growth and development of the baby in the womb is also affected by a lack of folate in the body, as well as vitamin B12 deficiency. Birth defects will increase in unborn babies, for example spina bifida.
Premature birth
Folate deficiency during pregnancy can increase the risk of the baby being born prematurely or before entering the 37th week of pregnancy. It can also affect your baby's development.
The emergence of cardiovascular disease
According to research, cardiovascular disease will increase when the body lacks folate. Cardiovascular disease is a term that describes a health condition that involves the blood vessels, heart, and the way blood circulates throughout the body.
Cause cancer
According to research, some cancers can be associated with folate deficiency. One example is stomach cancer. Cancer growth is not only caused by folate deficiency, but has the potential to contribute to cancer growth.