Vitamin deficiency anemia: Symptoms, Causes, Risk factors, Diagnosis, Treatment & Prevention

 

Anemia due to a lack of healthy red blood cells brought on by insufficient levels of vitamin B-12 and folate is known as vitamin deficiency anemia.

This can happen if you don't eat enough foods containing vitamin B-12 and folate, or if your body has trouble absorbing or processing these vitamins.

The body makes too-big, improperly functioning red blood cells when these nutrients aren't present. Their capacity to hold oxygen is lowered as a result.

Exhaustion, dyspnea, and vertigo are possible symptoms. Injections or pills containing vitamin supplements can make up for the deficiency.

When you have insufficient amounts of vitamin B12 or B9 (folate), you can develop vitamin deficiency anemia. Your body doesn't create enough healthy red blood cells when you have this type of anemia. This problem is more likely to develop if you have a disorder that impairs your body's ability to absorb nutrients.

What is vitamin deficiency anemia?

Anemia caused by a vitamin deficit occurs when the body fails to create enough healthy red blood cells. Low amounts of vitamin B12 or B9 (folate or folic acid) are the main causes of it.

Your body may manufacture abnormally large red blood cells instead of healthy red blood cells. Your body's cells cannot distribute oxygen as effectively as they should. Another term for vitamin deficiency anemia is macrocytic or megaloblastic anemia due to the unusually big red blood cells.

Also Read: Anemia: Symptoms, Causes, Diagnosis, Treatment & Prevention

Symptoms:

Anemia caused by a vitamin deficiency typically progresses gradually over months or years. Although they could start mild, signs and symptoms typically get worse as the deficiency gets worse. These could consist of:

• Fatigued

• Dizziness

• Pale or yellowish skin

• Irregular heartbeats

• Loss of weight

• Tingling or numbness in the feet and hands

• Weakened muscles

• Changes in personality

• Unsteady movements

• Mental confusion or forgetfulness

• Shortness of breath

Causes:

Not sufficient consumption of foods high in vitamin B-12 and folate, as well as problems with your body's absorption or processing of these nutrients, can result in vitamin deficiency anemia.

Deficiencies in vitamin B-12

Low vitamin B-12 levels may result from:

Eat a diet. Since meat, eggs, and milk are the main sources of vitamin B-12, those who don't eat these foods may need to take supplements. Certain foods, such as several breakfast cereals and nutritional yeast products, have been fortified with B-12.

Toxic anemia. This disorder develops when the stomach's intrinsic factor-producing cells are attacked by the immune system. The intestines cannot absorb B-12 without this material.

Surgeries gastric. The amount of intrinsic factor generated and the amount of space available for the absorption of vitamin B-12 may be reduced if surgically removed portions of your stomach or intestines.

Intestinal issues. Vitamin B-12 absorption can be hampered by Crohn's disease, celiac disease, and tapeworms that may be consumed through contaminated seafood.

Folate deficiency

Folate, also referred to as vitamin B-9, is mostly present in liver and dark green leafy vegetables. People who are unable to absorb folate from meals or who avoid foods containing folate may have a folate deficit.

 Absorption issues could be brought on by:

• Intestinal conditions like celiac disease

• Excision or bypass surgery on a sizable portion of the intestines

• Excessive consumption of alcohol

• Prescription pharmaceuticals, including several anti-seizure medicines

• The need for folate is higher in nursing and pregnant women, as well as in patients receiving dialysis for renal illness.

• Pregnancy-related birth abnormalities may result from a folate deficiency. However, in nations where folate is regularly added to food items like breads and cereals, folate insufficiency is becoming less common. 

Diagnosis:

You may undergo blood tests to assist detect vitamin deficiency anemias. These tests may look for:

• The number and appearance of red blood cells

• The blood's folate and vitamin B-12 levels

• Antibodies against intrinsic factors are indicative of pernicious anemia.

 Risk factors:

The following factors may make you more susceptible to vitamin deficiency anemia:

• Some autoimmune conditions, such as type 1 diabetes, celiac disease, and Crohn's disease.

• Surgery to remove a portion of your intestines or stomach.

• Older age.

• Long-term alcohol consumption.

Complications:

Deficiency in vitamin B-12 or folate increases the risk of numerous health issues, such as:

• Complications throughout pregnancy. If a growing fetus does not receive enough folate from its mother, brain and spinal cord birth abnormalities may result.

• Disorders of the nervous system. A vitamin B-12 deficiency if untreated might result in neurological issues including tingling in the hands and feet that doesn't go away or balance issues. It can cause mental disorientation and amnesia since vitamin B-12 is required for normal brain function.

• Gastric cancer. Intestinal or stomach malignancies are more common in those with pernicious anemia.

Treatment:

Doses of the deficient vitamin are used to treat vitamin deficiency anemia. Vitamin B-12 is typically administered by injection for pernicious anemia, and it may be necessary to take it consistently for the remainder of your life.

You can get vitamin B-12 as:

• Injections into the skin or a muscle

• Something that dissolves under the tongue, as a liquid or tablet

• Most folate-boosting medications are pills to be consumed, but some can be given intravenously—directly into a vein—through a thin, flexible tube

• Nasal spray

• Pill

You continue treatment until your vitamin levels increase – altering your diet can also often assist a lot. To keep a deficiency from recurring, you must stick with treatment if you have an underlying medical condition that contributed to your vitamin deficiency anemia.

Prevention:

A balanced, nutrient-rich diet can help you avoid certain types of vitamin deficiency anemia.

Vitamin B-12-rich foods include:

• Fish

• Poultry, beef, and liver

• Eggs

• Enhanced food items, like cereals for breakfast

• Cheese, milk, and yogurt

High-foliate foods include:

• Lima beans 

• Broccoli 

• Spinach, and asparagus

• Melons, bananas, strawberries, lemons, and oranges

• Products made using enhanced grains include bread, cereal, pasta, and rice

• Peanuts, yeast, kidneys, liver, and mushrooms

The majority of adults require the following daily dietary quantities of vitamins:

• Just 2.4 micrograms (mcg) of vitamin B-12

• 400 micrograms of folic acid, often known as folate.

Women who are nursing or pregnant could need more of each vitamin.

The majority of people consume enough vitamins from their diet. However, you may want to take a multivitamin if you have had gastric bypass surgery or if your diet is restricted.

References:

• Merck Manual, Consumer Version. Vitamin Deficiency Anemia (Megaloblastic anemia) (https://www.msdmanuals.com/en-gb/home/blood-disorders/anemia/vitamin-deficiency-anemia). Accessed 7/22/2022.

• Kellerman RD, et al. Pernicious anemia/megaloblastic anemia. In: Conn's Current Therapy 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed Aug. 18, 2021.

• Goldman L, et al., eds. Approach to the anemias. In: Goldman-Cecil Medicine. 26th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Aug. 18, 2021.

• Means RT, et al. Causes and pathophysiology of vitamin B12 and folate deficiency. https://www.uptodate.com/contents/search. Accessed Aug. 18, 2021.

• AskMayoExpert. Pernicious anemia. Mayo Clinic; 2021.

• Kaushansky K, et al., eds. Folate, cobalamin, and megaloblastic anemias. In: Williams Hematology. 10th ed. McGraw Hill; 2021. https://accessmedicine.mhmedical.com. Accessed Aug. 18, 2021.

• National Health Service UK. Vitamin B12 or folate deficiency anaemia (https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/). Accessed 7/22/2022.

• Means RT, et al. Treatment of vitamin B12 and folate deficiency. https://www.uptodate.com/contents/search. Accessed Aug. 18, 2021.

• Vitamin B12: Fact sheet for health professionals. National Institutes of Health Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional. Accessed Oct. 4, 2021.

• Smith EM, Tangpricha V. Vitamin D and Anemia: Insights into an Emerging Association (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4659411/). Curr Opin Endocrinol Diabetes Obes. 2015 Dec; 22(6): 432-438. Accessed 7/22/2022.