Vitamin B12 deficiency anemia

Severe vitamin B12 deficiency causes macrocytic anemia in which the red blood cells fail to mature properly and are fewer in number, larger in size and contain less oxygen-carrying hemoglobin than normal. Symptoms are similar to those of iron deficiency and include tiredness, pallor, lightheadedness, breathlessness, headache and irritability.

Vitamin B12 deficiency anemiaCauses of vitamin B12 deficiency anemia

Pernicious anemia

One of the most common causes of vitamin B12 deficiency anemia is the lack of a protein known as intrinsic factor, which is produced by the stomach and is necessary for vitamin B12 absorption. In this case, it is known as pernicious anemia. Lack of intrinsic factor tends to be an inherited tendency and is commonly seen in those over 60 years old. Researchers involved in a study done in California in 1996 used their results to estimate that as many as 800 000 elderly people in the United States have undiagnosed and untreated pernicious anemia.

Other causes

Vitamin B12 deficiency can occur in those whose dietary intakes of vitamin B12 are inadequate. It is also seen in babies who are breastfed by vegan mothers. Deficiency may also be due to malabsorption disorders, some types of gastritis, hyperthyroidism, kidney and liver diseases.

Diagnosis and treatment of vitamin B12 deficiency anemia

Because vitamin B12 is used very slowly and is stored in the body, deficiency symptoms may take a long time to appear. Body stores may be sufficient to last for three to five years in the absence of intrinsic factor or sufficient dietary intake.

The Schilling test is used to measure the ability of a person to absorb vitamin B12. If vitamin B12 deficiency is

due to inadequate dietary intake, it may be treated with dietary supplements. If it is due to lack of intrinsic factor, it is usually treated with vitamin B12 injections.

Vitamin B12 deficiency anemia and folic acid supplements

A high intake of folic acid can mask vitamin B12 deficiency as it can prevent the red blood cell changes but not the other symptoms of vitamin B12 deficiency. These include potentially irreversible nerve damage. Some experts are concerned that fortifying foods with folic acid may lead to vitamin B12 deficiency in susceptible people, such as the elderly and those on vegan diets. The US Food and Drug Administration recommends keeping total folic acid intake below 1 mg per day, unless under medical supervision.

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