Vitamin B12 or folate deficiency

Vitamin B12 or folate deficiency

Vitamin B12, or cobalamin, is naturally found in animal foods. It can also be added to foods or supplements. Vitamin B12 is needed to form red blood cells and DNA. It is also a key player in the function and development of brain and nerve cells.

Deficiency of Vitamin B12 causes neurological deterioration, megaloblastic anemia and possible impaired immune function. Deficiency can severely delay the development of infants and young children.

Anaemia is the general term for having either fewer red blood cells than normal or having an abnormally low amount of haemoglobin in each red blood cell.

How Much to Get?

The answer depends on things including your age, your eating habits and medical conditions, and what medications you take.

The average recommended amounts, measured in micrograms (mcg), vary by age:

  • Infants up to age 6 months: 0.4 mcg
  • Babies age 7-12 months: 0.5 mcg
  • Children age 1-3 years: 0.9 mcg
  • Kids age 4-8 years: 1.2 mcg
  • Children age 9-13 years: 1.8 mcg
  • Teens age 14-18: 2.4 mcg (2.6 mcg per day if pregnant and 2.8 mcg per day if breastfeeding)
  • Adults: 2.4 mcg (2.6 mcg per day if pregnant and 2.8 mcg per day if breastfeeding)
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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; this is 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 fad 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

Signs and Symptoms of Vitamin B12 Deficiency

Fatigue: Your body’s cells need B12 to function properly. As such, having inadequate B12 levels can decrease normal red blood cell production, which can impair oxygen delivery. Specifically, a deficiency in B12 or folate can cause megaloblastic anemia. This condition leads to the formation of large, abnormal, and immature red blood cells and impaired DNA synthesis. When your body doesn’t have enough healthy red blood cells to carry oxygen to tissues, you’ll likely feel weak and tired.

Pale or yellow skin: Like the condition called iron deficiency anemia, anemia related to B12 deficiency may make your skin pale due to a lack of fully-matured, healthy red blood cells in the body. B12 deficiency can also cause a condition called jaundice, which makes your skin and the whites of your eyes take on a yellowish color.

Headaches: In fact, headaches are amongst the most commonly reported symptoms related to B12 deficiency in both adults and kids. Some studies have shown that people who frequently experience certain types of headaches are more likely to have low B12 levels.

Depressive symptoms: B12 is essential to the proper functioning of your central nervous system, and a deficiency in this nutrient can impact your mental health. Having low levels of B12 can cause elevated levels of a sulfur-containing amino acid called homocysteine. In turn, this may contribute to the development of depression by increasing oxidative stress, DNA damage, and cell death in the body.

Difficulty concentrating and mental impairment: Because a deficiency in B12 negatively impacts the central nervous system, people with low or deficient B12 levels may feel foggy-headed and have difficulty concentrating and completing tasks.

Pain and inflammation of the mouth and tongue: Glossitis is a medical term that refers to an inflamed, red, and painful tongue. It can be caused by a B12 deficiency. In people with this deficiency, glossitis can appear alongside stomatitis, which is characterized by sores and inflammation in the mouth. Even though glossitis and stomatitis are common in people with B12 deficiency-related anemia, they can also occur without anemia and can be a sign of an early B12 deficienc

Treating vitamin B12 or folate deficiency

Most cases of vitamin B12 and folate deficiency can be easily treated with injections or tablets to replace the missing 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 meals or regular injections.

These treatments may be needed for the rest of your life.

Folic acid tablets are used to restore folate levels. These usually need to be taken for 4 months.

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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, yeast extract (such as Marmite) and specially fortified foods.

The best sources of folate include green vegetables, such as broccoli, brussels sprouts and peas.

Complications of vitamin B12 or folate deficiency

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.

Some complications improve with appropriate treatment, but others, such as problems with the nervous system, can be permanent.

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