Vitamin B12 or folate deficiency anemia is a type of anemia caused by the body’s inability to adequately absorb these crucial nutrients.

Vitamin B12 and folate are essential for the body. They help produce red blood cells and keep the nervous system in good health. If the body cannot absorb them appropriately from the diet, it may result in a deficiency condition which can lead to anemia.

Anemia is a condition where your body lacks enough red blood cells or hemoglobin to carry oxygen around your body efficiently. Hemoglobin is the protein in your red blood cells that carries oxygen.

People suffering from this type of anemia often feel tired and weak. They may also experience symptoms such as shortness of breath, lightheadedness, pale skin, diarrhea, weight loss, and numbness or tingling in their hands and feet.

Vitamin B12

It’s most common in people of northern European descent, the elderly, people with a family history of the condition, those who have had surgery on their stomach or small intestine, and in people with certain autoimmune diseases or digestive disorders like celiac disease or Crohn’s disease.

Treatment typically involves supplements or injections of the missing vitamin, and addressing the underlying absorption issue, if possible.

Causes of Vitamin B12 or folate deficiency anaemia

Vitamin B12 or folate deficiency anaemia occurs when a lack of these nutrients affects the body’s ability to produce fully functioning red blood cells. There are several causes for these deficiencies:

1. Poor Diet: This is a common cause of folate and sometimes B12 deficiency. Some people simply do not get enough of these nutrients in their diets. Foods rich in folate include leafy green vegetables, citrus fruits, and beans, while B12 is found in meat, eggs, and dairy.

2. Malabsorption: Some conditions cause the body to absorb less B12 or folate from food, such as atrophic gastritis, coeliac disease, Crohn’s disease, or pernicious anaemia, a condition where a person does not have enough of the protein intrinsic factor needed to absorb B12.

3. Medication: Certain medications can interfere with nutrient absorption, specifically medications like proton pump inhibitors, metformin, or long-term use of antacids.

4. Pregnancy and Breastfeeding: Increased requirements for folate and B12 during pregnancy and breastfeeding can lead to deficiency, particularly if dietary intake is not increased.

5. Alcoholism: Alcohol can hinder the body’s ability to absorb B12 and folate and can affect how nutrients are stored in the liver.

6. Age: Older adults often have diets that are deficient in these nutrients, and they may also suffer from conditions that interfere with nutrient absorption.

Please consult a doctor for medical advice if you believe you or someone else may have a deficiency in these nutrients.

Risk Factors of Vitamin B12 or folate deficiency anaemia

Vitamin B12 and folate are essential components that our body needs for creating red blood cells. A deficiency in either of these can lead to a type of anaemia called vitamin deficiency anaemia, specifically vitamin B12 deficiency anaemia or folate deficiency anaemia. Numerous factors can increase your risk of developing this condition. They include:

1. Dietary deficiencies: Not getting enough Vitamin B12 or folate in your diet can lead to deficiency. Vegans and vegetarians might not get enough B12 because it’s commonly found in animal products. Also, people whose diet lacks green leafy vegetables and fresh fruits can have folate deficiency.

2. Malabsorption issues: Certain conditions, such as celiac disease or pernicious anaemia, can affect the body’s ability to absorb these nutrients properly.

3. Alcohol abuse: Excessive alcohol consumption can interrupt the absorption and storage of folate and B12.

4. Gastrointestinal surgeries: Some weight loss or stomach surgeries can alter the digestion and absorption process, reducing the amount of vitamin B12 or folate that the body can absorb.

5. Age: Older individuals may have reduced levels of stomach acid, which is necessary for the absorption of vitamin B12.

6. Prescription medicines: Certain medications like antacids and some drugs used for type 2 diabetes may decrease the absorption of these vitamins.

7. Pregnancy or breastfeeding: During these periods, women may have increased nutritional needs that can exacerbate deficiencies or make it more likely to develop deficiencies.

8. Certain genetic disorders: Some conditions like MTHFR gene mutation can increase the risk of folate deficiency.

9. Health Conditions: Diseases such as Crohn’s or celiac disease can interfere with the absorption of nutrients including B12 or folate in the gut.

Maintaining a balanced diet rich in these vitamins, supplemented by vitamin tablets if necessary, and timely testing to uncover deficiencies, can help reduce the risk of developing these types of anaemia. It’s important to speak with a healthcare provider for personalized advice.

Signs and Symptoms of Vitamin B12 or folate deficiency anaemia

Vitamin B12 and folate are essential nutrients needed by the body to produce red blood cells. A deficiency in these vitamins can lead to anaemia, a condition characterised by a lower-than-normal quantity of red blood cells in the bloodstream.

Signs and symptoms of vitamin B12 or folate deficiency anaemia can vary but may include:

1. Fatigue: This is a common symptom as the body isn’t getting enough oxygen-rich blood, making individuals feel constantly tired.

2. Pale or yellowish skin: Red blood cells give skin its rosy color. Therefore, a lack of these cells can cause the skin to appear pale or yellowish.

3. Shortness of breath and dizziness: These can occur due to a lack of oxygen supply to the body.

4. Heart palpitations: This symptom may occur as the heart needs to work harder to circulate blood throughout the body.

5. Change in bowel habits: Vitamin B12 deficiency can also cause changes in digestion, leading to constipation, diarrhea, loss of appetite, or weight loss.

6. Numbness or tingling in the hands and feet: This is caused due to nerve damage from lack of Vitamin B12.

7. Mental issues like depression, irritability, and memory loss: These may occur as a result of the deficiency.

8. Sore tongue or mouth: In some cases, people may have a swollen and inflamed tongue (glossitis), mouth ulcers, pins and needles (paraesthesia), and a decreased sense of taste.

9. Vision disturbances: This occurs less commonly, but lack of B12 can damage the optic nerve and cause vision changes.

These symptoms can sometimes develop gradually and may not be recognized immediately. If you’re experiencing these symptoms, it’s essential to see a healthcare professional for proper diagnosis and treatment.

Diagnosis Vitamin B12 or folate deficiency anaemia

Vitamin B12 or folate deficiency anemia is a condition that arises when your body doesn’t get or absorb enough of these essential nutrients. These vitamins are crucial for producing red blood cells, which carry oxygen throughout your body. When your body does not have enough red blood cells or when these cells are not functioning properly, it can lead to anemia.

Vitamin B12 deficiency anemia can occur if your body does not get enough Vitamin B12 from the foods you eat, or if your body is unable to absorb it effectively. This can be due to a diet that lacks in Vitamin B12 (which is commonly found in meat, eggs, and dairy products), a condition known as pernicious anemia, where the body is unable to absorb Vitamin B12, or certain intestinal disorders that affect absorption.

Folate deficiency anemia, on the other hand, could be due to a diet lacking in folate (commonly found in legumes, leafy greens, and citrus fruits), certain medications, alcohol abuse, or intestinal disorders that affect absorption.

Common symptoms of Vitamin B12 or folate deficiency anemia include fatigue, weakness, pale skin, constipation, loss of appetite, weight loss, numbness or tingling in hands and feet, balance problems, confusion, dementia, depression and memory loss. Diagnosis is usually confirmed through blood tests and treatments include dietary changes, oral supplements, and in some cases, injections.

Treatment of Vitamin B12 or folate deficiency anaemia

The treatment of vitamin B12 or folate deficiency anemia depends on the exact cause of the condition. It usually involves supplementation of the deficient vitamin and addressing the underlying issues leading to the deficiency.

1. Vitamin B12 supplementation: If you are deficient in Vitamin B12, you may receive high dose B12 tablets or regular injections. The frequency and duration of these treatments can vary based on the severity of your deficiency.

2. Intake of folic acid: If you have a folate deficiency, you will typically be asked to consume folic acid tablets each day until your folate levels become normal.

3. Dietary changes: For both types of deficiency anemia, increasing the consumption of foods rich in the respective vitamins can be beneficial. Foods high in vitamin B12 include animal products like meat, fish, milk, and cheese. Folic acid is abundantly present in greens, beans, peas, and lentils.

4. Treating underlying conditions: Sometimes these deficiencies may be due to certain medical conditions or medications. For instance, pernicious anemia (a condition where the body cannot absorb vitamin B12 effectively from food) often requires lifelong treatment with vitamin B12 injections. Gastric issues and certain surgical procedures can also contribute to these deficiencies. In such cases, addressing these issues is an integral part of the treatment plan.

Always remember that this treatment should be guided by a healthcare professional and that self-medication isn’t safe or advisable.

Medications commonly used for Vitamin B12 or folate deficiency anaemia

Vitamin B12 or folate deficiency anaemia is typically treated with supplements or injections of the deficient vitamins. The medication choice depends on the cause of the deficiency.

1. Vitamin B12 Supplements: They are usually taken in pill form. For severe cases or for people with absorption problems, Vitamin B12 might be given by injection initially.

2. Folic Acid Supplements: This is the synthetic form of folate and is used for treating folate deficiency anemia. It can be taken as an oral tablet or injection.

3. Pernicious Anemia Treatment: Pernicious anemia is a common cause of vitamin B12 deficiency, where the immune system attacks healthy cells in your stomach, preventing proper B12 absorption. Hydroxocobalamin injections are commonly used to treat pernicious anaemia.

Additionally, dealing with the root cause of the deficiency is also paramount. This might involve dietary changes to include more foods rich in these vitamins, treating underlying conditions that cause the deficiency (like celiac or Crohn’s disease), or in some cases, surgical intervention if there are issues with the digestive system.

It’s crucial to be under the care of a healthcare provider to monitor the response to these treatments by regularly checking blood tests. It’s also crucial to adhere to the prescribed treatment regimen, even if feeling better, since stopping these medications can result in the return of the anemia.

Always consult a healthcare professional or doctor before starting any medication regimen. Side effects, interactions with other medicines, and individual health conditions need to be considered each time a new medicine is prescribed.

Prevention of Vitamin B12 or folate deficiency anaemia

Vitamin B12 or folate deficiency anaemia can be prevented through dietary changes and in some cases, dietary supplementation. Here are some strategies that can be implemented:

1. Balanced Diet: Ensure that you maintain a diet that is rich in these vitamins. For vitamin B12, good sources are meat, salmon, cod, milk, cheese, eggs, and some fortified breakfast cereals. Folate can be obtained from sources like green leafy vegetables, brown rice, granary bread, and fortified breakfast cereals.

2. Supplements: In some cases, a balanced diet might not be enough, especially for people who have difficulty absorbing these vitamins from food. In such cases, vitamin B12 and folate supplements may be recommended. Always consult your doctor before starting any supplementation.

3. Regular screenings: Regular blood tests can detect deficiencies early, minimising the risk of developing anaemia.

4. Vegan and Vegetarian considerations: If you’re vegan or vegetarian, you might find it hard to get enough B12 as it is primarily found in animal products. In this case, you should consider fortified foods or a vitamin B12 supplement.

5. Medications: Certain types of medicines might interfere with the body’s ability to absorb these vitamins, such as antacids, proton pump inhibitors, and metformin. If you’re on these medicines, work with your healthcare provider to manage your intake of vitamins.

6. Limit Alcohol: Excessive alcohol intake can make it hard for your body to absorb folate and Vitamin B12. Limiting your alcohol intake can prevent this.

Remember, it’s important to consult your healthcare provider to understand more about your individual requirements, as the need for these vitamins can vary greatly based on your health status and age.

FAQ’s about Vitamin B12 or folate deficiency anaemia

Vitamin B12 or folate deficiency anaemia refers to a decrease in red blood cells caused by a lack of either of these essential vitamins within the body. Here are some frequently asked questions about it:

1. What are the symptoms of Vitamin B12 or folate deficiency anaemia?
Symptoms include fatigue, lack of energy, pale skin, breathlessness, irritability, depression, and poor memory and concentration.

2. What causes Vitamin B12 or folate deficiency anaemia?
Vitamin B12 deficiency can be caused by a lack of the vitamin in the diet, a condition called pernicious anaemia, or an issue with absorption in the stomach or intestines. Folate deficiency is usually caused by a poor diet, an increased demand (e.g., during pregnancy), certain medications, or conditions affecting absorption in the gut.

3. Who is at risk of Vitamin B12 or folate deficiency anaemia?
Those with a vegan diet, those who are pregnant, elderly people, and people with certain gut conditions like Crohn’s disease are at a higher risk.

4. How is Vitamin B12 or folate deficiency anaemia diagnosed?
These conditions can be diagnosed through a simple blood test. The blood test allows the doctor to analyze your levels of these vitamins and assess the size of your red blood cells.

5. How is Vitamin B12 or folate deficiency anaemia treated?
Treatment involves supplementing the missing vitamins either through diet, oral supplements or injections. For vitamin B12 deficiency, injections are often given, while folate deficiency can generally be treated with dietary changes and oral supplements.

6. Can I prevent Vitamin B12 or folate deficiency anaemia?
Eating a healthy, balanced diet that includes all the necessary nutrients can help prevent these conditions. Those at risk of B12 deficiency may need to take supplements, and those on a vegan diet should ensure their foods are fortified with B12.

7. Is it serious if not treated?
If untreated, vitamin B12 or folate deficiency anemia can lead to complications like a weakened immune system, neurological problems, cardiovascular issues, and, in severe cases, pregnancy complications with folate deficiency.

8. What are the sources of Vitamin B12 and folate?
Vitamin B12 is mainly found in animal products, including meat, milk, eggs, and fish. Folate can be found in green, leafy vegetables, citrus fruits, beans, nuts, and folic acid-fortified cereals and bread.

Always consult your doctor with health-related questions and never self-medicate without a health professional’s guidance.

Useful links

Vitamin B12 or folate deficiency anaemia is a condition in which your body does not have enough vitamin B12 or folate (also known as folic acid), leading to the production of larger than normal red blood cells, and thus causing anaemia. Symptoms of this condition may include fatigue, lack of energy, breathlessness, and noticeable heartbeat.

Here are some peer-reviewed journals that discuss Vitamin B12 or folate deficiency anaemia and their treatments. Please keep in mind that access to these articles may require a subscription or purchase:


Remember to consult a healthcare provider for proper diagnosis and treatment plans. These articles are for informative purposes and are not a substitute for professional medical advice.

Complications of Vitamin B12 or folate deficiency anaemia

Vitamin B12 or folate deficiency anaemia can occur when your body doesn’t get enough of these nutrients, leading to a reduction in the production of healthy red blood cells. Complications can arise when the deficiency is not treated in time and can include:

Vitamin B12

1. Neurological complications: Both Vitamin B12 and folate are involved in the healthy functioning of the nervous system. Their deficiency may lead to neurological complications such as memory loss, disturbed coordination which may affect normal walking, numbness or tingling sensation in hands and feet, and even psychiatric problems like depression, irritability, and personality changes.

2. Cardiovascular problems: Anaemia can put more strain on the cardiovascular system as the heart has to pump more blood to compensate for the lack of oxygen in the body. This can cause an enlarged heart or heart failure.

3. Pregnancy complications: Folate deficiency anaemia during pregnancy can lead to birth defects in the baby, like neural tube defects including spina bifida and anencephaly.

4. Gastrointestinal symptoms: These may include a sore mouth and tongue, appetite loss, constipation, or weight loss.

5. Digestive problems: Pernicious anaemia can affect the body’s ability to absorb nutrients correctly, leading to other deficiencies and digestive problems.

6. Growth problems: In severe cases in children, a vitamin B12 or folate deficiency can lead to growth and developmental problems.

7. Weakness or fatigue: Because of the lack of red blood cells to carry oxygen, you can feel weak or tired.

8. Megaloblastic anemia: It can also cause your body to produce unusually large red blood cells that can’t function properly.

The severity of the symptoms and complications can greatly vary between individuals, and in some cases, irreversible damage may occur. It is essential to seek medical advice if you suspect you may be deficient in vitamin B12 or folate. Regular blood tests and an adequate diet can prevent these complications.

Home remedies of Vitamin B12 or folate deficiency anaemia

Vitamin B12 and folate deficiency anaemia are conditions that can be managed with a combination of medical treatments and home remedies. These home remedies might be helpful in preventing or managing these conditions, but are in no way a replacement for professional medical advice.

1. Nutritional Diet:
Vitamin B12: Foods rich in Vitamin B12 include shellfish, liver, fish, fortified cereals, red meat, yogurt, milk, cheese and eggs.
Folate (Vitamin B9): Foods rich in Folate include dark green leafy vegetables, fruits, nuts, beans, peas, seafood, eggs, dairy products, meat, and grains.

2. Supplements: If you cannot get enough from food alone, oral supplements of Vitamin B12 or folate can be consumed, but only under a healthcare provider’s advice.

3. Gut health: Maintaining good gut health can also help with the absorption of these vitamins. You can do this by eating a balanced diet, exercising, staying hydrated, and consuming probiotics such as yoghurt.

4. Healthy Lifestyle: Refraining from excessive alcohol consumption, as alcohol can hinder the absorption of these vitamins. Smoking cessation is also advisable.

5. Regular Check-ups: Regular check-ups can help monitor your blood levels and may catch a deficiency before symptoms worsen.

Remember to consult with your health provider before starting any new dietary or supplement routine. These home remedies are meant to be supplemental and should not replace any prescribed treatments for vitamin B12 or folate deficiency anaemia. Depending on the severity of your anemia, your healthcare provider may suggest injections or higher dose oral supplements which can fulfill the deficiency more effectively.

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Last Update: January 13, 2024