Deficiency due to inadequate consumption is unlikely in other people. The most common cause of vitamin B12 deficiency is inadequate absorption. The following conditions can cause absorption to be inadequate:. Overgrowth of bacteria Small Intestinal Bacterial Overgrowth SIBO Small intestinal bacterial overgrowth is a disorder in which poor movement of intestinal contents allows certain normal intestinal bacteria to grow excessively, causing diarrhea and poor absorption Impaired absorption malabsorption disorders Overview of Malabsorption Malabsorption syndrome refers to a number of disorders in which nutrients from food are not absorbed properly in the small intestine.
Certain disorders, infections, and surgical procedures can Inflammatory bowel disease Overview of Inflammatory Bowel Disease IBD In inflammatory bowel diseases, the intestine bowel becomes inflamed, often causing recurring abdominal pain and diarrhea. The two primary types of inflammatory bowel disease IBD are Crohn Fish tapeworm infection Tapeworm Infection Tapeworm infection of the intestine occurs mainly when people eat raw or undercooked contaminated pork, beef, or freshwater fish or, for the dwarf tapeworm, contaminated food or water.
HIV is transmitted Bariatric surgery Bariatric Surgery Bariatric weight-loss surgery alters the stomach, intestine, or both to produce weight loss. In the United States, about , people have bariatric surgery each year. This number accounts Drugs such as antacids and metformin used to treat diabetes Drug Treatment of Diabetes Mellitus Many people with diabetes require drugs to lower blood glucose levels, relieve symptoms, and prevent complications of diabetes.
There are two types of diabetes mellitus Type 1, in which the Intrinsic factor may be lacking because abnormal antibodies, produced by an overactive immune system, attack and destroy the stomach cells that produce intrinsic factor—an autoimmune reaction called autoimmune metaplastic atrophic gastritis. Intrinsic factor may be lacking because the part of the stomach where intrinsic factor is produced was surgically removed.
Vitamin B12 deficiency due to lack of intrinsic factor causes a type of anemia called pernicious anemia. Among older people, absorption may be inadequate because stomach acidity is decreased.
However, the vitamin B12 found in vitamin supplements can continue to be well absorbed even in people with decreased stomach acid.
Liver disorders Overview of Liver Disease Liver disease can manifest in many different ways. Characteristic manifestations include Jaundice a yellowish discoloration of the skin and whites of the eyes Cholestasis reduction or stoppage Anemia Vitamin Deficiency Anemia Vitamin deficiency anemia results from low or depleted levels of vitamin B12 or folate folic acid.
Consequently, symptoms may be mild even when anemia is severe. If severe, anemia causes shortness of breath, dizziness, and a rapid heart rate. Occasionally, the spleen and liver enlarge. Test your knowledge. Which of the following findings is most indicative of niacin deficiency? More Content. Click here for Patient Education. The most common causes of folate deficiency are.
Inadequate intake usually in patients with undernutrition or alcoholism. Complete blood count and serum vitamin B12 and folate levels. Supplemental oral folate. Prolonged cooking destroys folate, but many dietary staples are supplemented with folate. Measure serum folate and vitamin B12 levels in patients who have megaloblastic anemia. To treat deficiency, give patients supplemental folate to mcg orally once a day.
Was This Page Helpful? Yes No. Niacin Deficiency. Vitamin B12 Deficiency. Megaloblastic Macrocytic Anemias.
Wernicke Encephalopathy. Although it's less common, people with vitamin B12 deficiency caused by a prolonged poor diet may be advised to stop taking the tablets once their vitamin B12 levels have returned to normal and their diet has improved.
If you're a vegetarian or vegan, or are looking for alternatives to meat and dairy products, there are other foods that contain vitamin B12, such as yeast extract including Marmite , as well as some fortified breakfast cereals and soy products.
Check the nutrition labels while food shopping to see how much vitamin B12 different foods contain. If your vitamin B12 deficiency is not caused by a lack of vitamin B12 in your diet, you'll usually need to have an injection of hydroxocobalamin every 2 to 3 months for the rest of your life. If you have had neurological symptoms that affect your nervous system, such as numbness or tingling in your hands and feet, caused by a vitamin B12 deficiency, you'll be referred to a haematologist and may need to have injections every 2 months.
For injections of vitamin B12 given in the UK, hydroxocobalamin is preferred to an alternative called cyanocobalamin. This is because hydroxocobalamin stays in the body for longer. If you need regular injections of vitamin B12, cyanocobalamin would need to be given once a month, whereas hydroxocobalamin can be given every 3 months. Cyanocobalamin injections are not routinely available on the NHS as hydroxocobalamin is the preferred treatment. But if you need replacement tablets of vitamin B12, these will usually be in the form of cyanocobalamin.
To treat folate deficiency anaemia, your GP will usually prescribe daily folic acid tablets to build up your folate levels. Most people need to take folic acid tablets for about 4 months.
But if the underlying cause of your folate deficiency anaemia continues, you may have to take folic acid tablets for longer, possibly for life. Before you start taking folic acid, your GP will check your vitamin B12 levels to make sure they're normal. This is because folic acid treatment can sometimes improve your symptoms so much that it masks an underlying vitamin B12 deficiency.
A blood test is often carried out around 10 to 14 days after starting treatment to assess whether treatment is working. This is to check your haemoglobin level and the number of the immature red blood cells reticulocytes in your blood. Another blood test may also be carried out after approximately 8 weeks to confirm your treatment has been successful. If you have been taking folic acid tablets, you may be tested again once the treatment has finished usually after 4 months.
Most people who have had a vitamin B12 or folate deficiency will not need further monitoring unless their symptoms return or their treatment is ineffective. If your GP feels it's necessary, you may have to return for an annual blood test to see whether your condition has returned. As most cases of vitamin B12 deficiency or folate deficiency can be easily and effectively treated, complications are rare.
But complications can occasionally develop, particularly if you have been deficient in either vitamin for some time. All types of anaemia, regardless of the cause, can lead to heart and lung complications as the heart struggles to pump oxygen to the vital organs. A lack of vitamin B12 can cause neurological problems, which affect your nervous system, such as:.
Vitamin B12 deficiency can sometimes lead to temporary infertility, an inability to conceive. If you have a vitamin B12 deficiency caused by pernicious anaemia, a condition where your immune system attacks healthy cells in your stomach, your risk of developing stomach cancer is increased. If you're pregnant, not having enough vitamin B12 can increase the risk of your baby developing a serious birth defect known as a neural tube defect. Research has shown a lack of folate in your body may increase your risk of cardiovascular disease CVD.
CVD is a general term that describes a disease of the heart or blood vessels, such as coronary heart disease. Research has shown that folate deficiency can increase your risk of some cancers, such as colon cancer.
A lack of folate during pregnancy may increase the risk of the baby being born prematurely before the 37th week of pregnancy or having a low birth weight. The risk of placental abruption may also be increased. This is a serious condition where the placenta starts to come away from the inside of the womb wall, causing tummy abdominal pain and bleeding from the vagina.
As with a vitamin B12 deficiency, a lack of folate can also affect an unborn baby's growth and development in the womb uterus. This increases the risk of neural tube defects, such as spina bifida, developing in the unborn baby.
It's recommended that all women who could get pregnant should take a daily supplement of folic acid. You should take a microgram supplement of folic acid every day before you get pregnant, and up until you're 12 weeks pregnant. Skip to Main Content. Search the site. Anaemia, vitamin B12 and folate deficiency. On this page.
Red blood cells carry oxygen around the body using a substance called haemoglobin. There are several different types of anaemia and each one has a different cause. For example, iron deficiency anaemia happens when the body does not contain enough iron. Symptoms of vitamin B12 or 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 paraesthesia a sore and red tongue mouth ulcers muscle weakness disturbed vision psychological problems, which may include depression and confusion problems with memory, 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.
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, 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 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 Treating vitamin B12 or folate deficiency anaemia 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. Fairfield KM. Vitamin supplementation in disease prevention. Folate: Fact sheet for health professionals. Accessed Oct. Kaushansky K, et al. Folate, cobalamin, and megaloblastic anemias. In: Williams Hematology.
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