Vitamin B12 or B9 (commonly called folate) deficiency anaemia occurswhen a lack of vitamin B12 or folate causes the body to produce abnormally large red blood cells that cannot function properly.
Red blood cells carry oxygen around the body using a substance called haemoglobin.
Anaemia is the general termfor having either fewer red blood cells than normal or having an abnormally low amount of haemoglobin in each red blood cell.
Symptoms of vitamin B12or folate deficiency
Vitamin B12 and folate perform several important functions in the body, including keeping the nervous system healthy.
A deficiency in either of these vitamins can cause a wide range of problems, including:
- extreme tiredness
- a lack of energy
- pins and needles
- a sore and red tongue
- mouth ulcers
- muscle weakness
- problems with your vision
- psychological problems, which can range from mild depression or anxiety toconfusion and dementia
- problems withmemory, understanding and judgement
Some of these problems can also happen if you have a deficiency in vitamin B12 or folate but do not have anaemia.
When to see a GP
See a GP if you think you may have a vitamin B12 or folate deficiency.
These conditions can often be diagnosed based on your symptoms and the results of ablood test.
It's important for vitamin B12 or folate deficiency anaemia to be diagnosed and treated as soon as possible.
This is because although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible.
Causes of a vitamin B12 or folate deficiency
There are a number of problems that can lead to a vitamin B12 or folate deficiency.
These include:
- pernicious anaemia–where your immune system attacks healthy cells in your stomach, preventing your body absorbing vitamin B12 from the food you eat; thisis the most common cause of vitamin B12 deficiency in the UK
- a lack of these vitamins in your diet–this is uncommon, but can happen if you have a vegan diet and do not take vitamin B12 supplements or eat foods fortified with vitamin B12 , follow a restrictive diet or have a generally poor diet for a long time
- medicine–certain medicines, including anticonvulsants and proton pump inhibitors (PPIs), can affect how much of these vitamins your body absorbs
Both vitamin B12 deficiency and folate deficiency are more common in older people, affecting around 1 in 10 people aged 75 or over and 1 in 20 people aged 65 to 74.
Treating vitamin B12 or folatedeficiency anaemia
Most cases of vitamin B12 and folate deficiency can beeasily treated with injections or tablets to replace themissing vitamins.
Vitamin B12 supplements are usually given by injection at first.
Then, depending on whether your B12 deficiency is related to your diet, you'll either require B12 tablets between mealsor regular injections.
Treatments may last until your vitamin B12 levels have improved or you may need treatment for the rest of your life.
Folic acid tablets are used to restore folate levels. These usually need to be taken for 4 months.
In some cases, improving your diet can help treat the condition and prevent it coming back.
Vitamin B12 is found in meat, fish, eggs,dairy products and specially fortified foods.
Good sources of folate include green vegetables, such as broccoli, brussels sprouts and peas.
Complications of vitamin B12 or folate deficiency anaemia
Although it's uncommon, vitamin B12 or folate deficiency (with or without anaemia) can lead to complications, particularly if you have been deficient in vitamin B12 or folate for some time.
Potential complications can include:
- problems with the nervous system
- temporary infertility
- heart conditions
- pregnancy complications and birth defects
Adults with severe anaemia are also at risk of developing heart failure.
Somecomplications improve with appropriate treatment, but others, such as problems with the nervous system, can sometimes be permanent.
Page last reviewed: 20 February 2023
Next review due: 20 February 2026
As an enthusiast in the field of nutrition and health, I've delved deep into the specifics of various vitamins and their impact on the human body. In particular, the role of Vitamin B12 and folate (Vitamin B9) is a significant area of expertise. These vitamins play pivotal roles in various physiological functions, from red blood cell production to neurological health. Let's break down the concepts in the article you've provided:
Vitamin B12 and Folate Deficiency Anaemia
1. Red Blood Cell Abnormalities
- Abnormally Large Red Blood Cells: Deficiency in either Vitamin B12 or folate can lead to the production of unusually large red blood cells (macrocytes) which fail to function effectively.
2. Role of Red Blood Cells
- Transporting Oxygen: Red blood cells carry oxygen throughout the body via hemoglobin, which relies on these vitamins for proper function.
3. Symptoms of Deficiency
- General Symptoms: Extreme tiredness, lack of energy, tingling sensations (pins and needles), sore and red tongue, mouth ulcers, muscle weakness, vision problems, and various psychological issues from mild depression to confusion and dementia can manifest due to deficiencies in these vitamins.
4. Importance of Diagnosis
- Consulting a GP: Seeking medical advice becomes crucial upon suspecting a deficiency, as timely diagnosis and treatment are vital. Blood tests help in diagnosing these deficiencies.
5. Causes of Deficiency
- Pernicious Anaemia: Autoimmune attack on stomach cells hindering Vitamin B12 absorption, a common cause in the UK.
- Dietary Deficiencies: Lack of these vitamins due to a vegan diet, poor diet, or long-term dietary restrictions.
- Medication Interactions: Certain medications like anticonvulsants and proton pump inhibitors (PPIs) can interfere with the absorption of these vitamins.
6. Treatment
- Vitamin Replacement: Deficiencies are typically treated with injections or tablets to supplement the missing vitamins.
- Duration of Treatment: Treatment duration varies, and it might necessitate lifelong supplementation or dietary changes depending on the cause.
7. Dietary Sources
- Vitamin B12: Found in meat, fish, eggs, dairy products, and fortified foods.
- Folate (Vitamin B9): Present in green vegetables like broccoli, brussels sprouts, and peas.
8. Complications
- Nervous System and Health Complications: Long-term deficiencies can lead to issues with the nervous system, heart conditions, temporary infertility, pregnancy complications, birth defects, and potential heart failure.
9. Management of Complications
- Effects of Treatment: Appropriate treatment can ameliorate some complications, while others might persist or become irreversible, especially those related to the nervous system.
Understanding these concepts is crucial, as timely detection and intervention can mitigate the risks associated with Vitamin B12 and folate deficiencies, preventing severe health complications.
