Anemia z niedoboru witamin
Zapobieganie i profilaktyka

Anemia z niedoboru witamin, głównie witaminy B12 i kwasu foliowego, wynika z niedostatecznej podaży lub zaburzeń wchłaniania tych składników. Profilaktyka opiera się na zbilansowanej diecie bogatej w produkty takie jak chude mięso, ryby, nabiał, zielone warzywa liściaste oraz wzbogacone produkty zbożowe. Suplementacja witaminy B12 jest wskazana u osób po 50. roku życia, po operacjach bariatrycznych (1 mg/dobę), stosujących metforminę powyżej 4 miesięcy, inhibitorów pompy protonowej lub blokerów H2 przez ponad 12 miesięcy, a także u wegan. Kwas foliowy suplementuje się u kobiet planujących ciążę i w ciąży w dawce 400 μg/dobę, a w przypadku wcześniejszych ciąż z wadą cewy nerwowej – 5 mg/dobę. U niemowląt zaleca się suplementację żelaza od 4. miesiąca życia, a u kobiet ciężarnych WHO rekomenduje 60 mg żelaza elementarnego i 0,4 mg kwasu foliowego dziennie, z uwzględnieniem unikania jednoczesnego podawania wapnia, który hamuje wchłanianie żelaza, szczególnie przy hemoglobinie <11 g/dl.

Zapobieganie anemii z niedoboru witamin

Anemia z niedoboru witamin może wystąpić, gdy w diecie brakuje odpowiedniej ilości witamin B12 i kwasu foliowego lub gdy organizm ma problemy z wchłanianiem i przetwarzaniem tych witamin. Zapobieganie temu schorzeniu polega na odpowiednim odżywianiu, suplementacji oraz leczeniu chorób podstawowych wpływających na wchłanianie witamin.12

Zalecenia dietetyczne

Większość przypadków anemii z niedoboru witamin można zapobiec poprzez zbilansowaną dietę zawierającą różnorodne produkty spożywcze. U większości osób odpowiednio skomponowana dieta dostarcza wystarczających ilości niezbędnych witamin.12

Produkty bogate w witaminę B12 obejmują:345

  • Chude czerwone mięso i drób
  • Ryby (np. sum i łosoś) oraz owoce morza (małże, ostrygi)
  • Mleko, jogurt, ser i wzbogacone zamienniki mleka pochodzenia roślinnego
  • Wzbogacone płatki śniadaniowe
  • Jaja

Produkty bogate w kwas foliowy (witaminę B9) to:678

  • Zielone warzywa liściaste (szpinak, kapusta, brokuły)
  • Sok pomarańczowy i owoce cytrusowe
  • Produkty pełnoziarniste
  • Rośliny strączkowe (soczewica, fasola)
  • Wzbogacane produkty zbożowe

Dla zwiększenia wchłaniania żelaza, które jest również ważne w zapobieganiu anemii, zaleca się spożywanie produktów bogatych w witaminę C jednocześnie z pokarmami zawierającymi żelazo. Witamina C zawarta w sokach cytrusowych, np. soku pomarańczowym, pomaga organizmowi lepiej wchłaniać żelazo z diety.97

Należy również unikać produktów spowalniających wchłanianie żelaza podczas spożywania pokarmów bogatych w żelazo, takich jak otręby zbożowe (mąka pełnoziarnista, płatki owsiane), herbata, kawa, kakao i wapń.7 Jeśli przyjmuje się suplementy wapnia i żelaza, należy je stosować o różnych porach dnia.7

Suplementacja witaminowa

Wskazania do suplementacji witaminy B12:101112

Wskazania do suplementacji kwasu foliowego:13141516

  • Kobiety planujące ciążę i będące w ciąży – zalecana dawka to 400 μg (0,4 mg) dziennie od momentu zaprzestania antykoncepcji do 12. tygodnia ciąży w celu zapobiegania wadom cewy nerwowej u płodu
  • Kobiety, które urodziły dziecko z wadą cewy nerwowej – zalecana dawka to 5 mg dziennie przed i podczas kolejnej ciąży
  • Pacjenci poddawani dializie nerek – dawka profilaktyczna od 5 mg dziennie do tygodniowo, w zależności od diety i wskaźnika hemolizy
  • Zapobieganie działaniom niepożądanym metotreksatu w chorobach reumatycznych u dorosłych powyżej 18 roku życia – 5 mg raz w tygodniu

Suplementacja u niemowląt i dzieci

Zapobieganie anemii z niedoboru witamin u niemowląt i dzieci wymaga szczególnej uwagi:9171819

  • Niemowlęta karmione wyłącznie piersią lub częściowo piersią powinny otrzymywać codzienną suplementację żelaza od 4. miesiąca życia, dopóki nie zaczną jeść pokarmów bogatych w żelazo
  • Niemowlęta przedwcześnie urodzone wymagają większej suplementacji żelaza niż niemowlęta urodzone o czasie
  • Aby zapobiec anemii z niedoboru żelaza u niemowląt, nie należy podawać mleka krowiego przed ukończeniem 1. roku życia
  • Po ukończeniu 6. miesiąca życia należy wprowadzić do diety niemowląt wzbogacone żelazem płatki zbożowe lub puree z mięsa co najmniej dwa razy dziennie
  • Po ukończeniu 1. roku życia należy ograniczyć spożycie mleka krowiego do mniej niż 590 ml (20 uncji) dziennie, ponieważ nadmierne spożycie mleka często zastępuje inne pokarmy, w tym te bogate w żelazo

Zapobieganie niedoborom witamin u dzieci w wieku przedszkolnym i nastolatków:1920

  • Włączenie chudego czerwonego mięsa do diety 3-4 razy w tygodniu
  • Oferowanie alternatyw dla mięsa, takich jak suszone fasole, soczewica, ciecierzyca, konserwowane fasole, drób, ryby, jaja i niewielkie ilości orzechów i past orzechowych
  • W przypadku diety wegetariańskiej lub wegańskiej wskazana jest konsultacja z dietetykiem
  • Zapewnienie w diecie witaminy C, która pomaga organizmowi wchłaniać więcej żelaza
  • Zachęcanie do spożywania pokarmów stałych podczas posiłków i dbanie o to, aby dzieci nie wypełniały się napojami między posiłkami
  • U nastolatków – promowanie wzbogaconych płatków śniadaniowych i produktów pełnoziarnistych

Suplementacja w ciąży

Kobiety ciężarne są grupą o zwiększonym ryzyku niedoborów witamin, stąd szczególne zalecenia dotyczące suplementacji:2122232425

Światowa Organizacja Zdrowia (WHO) zaleca w krajach o występowaniu anemii powyżej 40% codzienną suplementację 60 mg żelaza elementarnego wraz z 0,4 mg kwasu foliowego u kobiet ciężarnych. W Ameryce Północnej zaleca się rutynową suplementację 15-30 mg/dobę żelaza elementarnego w czasie ciąży.24

Kobiety ciężarne potrzebują więcej żelaza i kwasu foliowego niż kobiety, które nie są w ciąży. Niedobór kwasu foliowego podczas ciąży może prowadzić do grupy wad wrodzonych znanych jako wady cewy nerwowej, takich jak rozszczep kręgosłupa.8

Suplementację należy podawać w innym czasie niż wapń, ponieważ wapń hamuje wchłanianie żelaza, zwłaszcza jeśli kobieta ma anemię (hemoglobina poniżej 11 g/dl).21

Profilaktyka u osób z grup ryzyka

Określone populacje są narażone na wystarczająco wysokie ryzyko niedoboru witamin, by uzasadnić profilaktyczną suplementację:212627

  • Osoby po zabiegach chirurgicznych – pacjenci po całkowitej gastrektomii, operacjach bariatrycznych, ilektomii, pankreatektomii powinni otrzymywać profilaktyczną suplementację witaminy B122628
  • Osoby z chorobami przewlekłymi – pacjenci z zanikowym zapaleniem błony śluzowej żołądka, przewlekłymi chorobami zapalnymi jelita cienkiego, chorobą Crohna, celiakią powinni być objęci monitorowaniem poziomu witamin2629
  • Osoby przyjmujące określone leki długoterminowo – metforminę (sprawdzanie poziomu B12 po 4 miesiącach stosowania), inhibitory pompy protonowej lub blokery H2 (monitorowanie po 12 miesiącach stosowania)1027
  • Osoby starsze – osoby po 50. roku życia, szczególnie narażone na rozwój anemii złośliwej z powodu achlorhydrii2611
  • Weganie i ścisłi wegetarianie – powinni kontynuować suplementację witaminy B12, szczególnie podczas ciąży i karmienia piersią2611
  • Regularni dawcy krwi – mogą wymagać suplementacji żelaza21
  • Osoby z obciążeniem rodzinnym – członkowie rodzin pacjentów z anemią złośliwą powinni być świadomi zwiększonego ryzyka rozwoju tej choroby i szukać pomocy medycznej, jeśli wystąpią u nich objawy anemii lub symptomy neurologiczne26

Monitorowanie stanu witamin

Regularne monitorowanie stanu witamin jest istotne w zapobieganiu anemii z niedoboru witamin, szczególnie u osób z grup ryzyka:42830

  • Osoby po operacji żołądka powinny mieć monitorowany poziom B12 co 3 miesiące po zabiegu, a następnie raz w roku28
  • Pacjenci przyjmujący metforminę powinni mieć sprawdzany poziom witaminy B1227
  • W przypadku podejrzenia niedoboru kwasu foliowego należy uzyskać poziom folianów w czerwonych krwinkach (RBC), a nie w surowicy, aby określić, czy istnieje rzeczywisty niedobór kwasu foliowego30
  • W celu określenia niedoboru żelaza lekarz zbada poziom ferrytyny w surowicy30

Inne strategie zapobiegania

Oprócz odpowiedniej diety i suplementacji, istnieją również inne ważne strategie zapobiegania anemii z niedoboru witamin:62931

  • Ograniczenie spożycia alkoholu – częste spożywanie alkoholu może uszkodzić układ trawienny i utrudnić organizmowi wchłanianie witaminy B12293132
  • Zapobieganie i leczenie malarii i innych infekcji pasożytniczych6
  • Leczenie chorób przewlekłych – takich jak otyłość i problemy trawienne629
  • Przestrzeganie zaleceń dotyczących leczenia chorób przewodu pokarmowego – takich jak choroba Crohna czy celiakia29
  • Unikanie nadużywania podtlenku azotu31
  • Zachowanie co najmniej 24-miesięcznego odstępu między ciążami6
  • Opóźnienie zaciśnięcia pępowiny po porodzie (nie wcześniej niż 1 minutę po urodzeniu)6

Fortyfikacja żywności

Wzbogacanie żywności witaminami jest ważną strategią zdrowia publicznego w zapobieganiu anemii z niedoboru witamin:2316

Fortyfikacja mąki kwasem foliowym jest obowiązkowa w wielu krajach w celu zapobiegania wadom cewy nerwowej u niemowląt. Wykazano, że wzbogacanie kwasem foliowym zmniejsza częstość występowania wad cewy nerwowej w krajach, w których zostało wdrożone.16

Dostępnych jest wiele fortyfikowanych produktów spożywczych, w tym:531

  • Płatki śniadaniowe wzbogacone witaminami
  • Drożdże odżywcze
  • Mleko roślinne wzbogacone witaminami
  • Niektóre rodzaje chleba

Należy sprawdzać etykiety żywności (informacje o wartości odżywczej), aby zobaczyć, czy produkt został wzbogacony witaminą B12 lub innymi witaminami.5

Interwencje w zakresie zdrowia publicznego

Światowa Organizacja Zdrowia (WHO) opracowała wytyczne mające na celu zmniejszenie częstości występowania anemii poprzez zapobieganie i leczenie. Wytyczne te mają na celu zwiększenie różnorodności diety, poprawę praktyk żywieniowych niemowląt oraz poprawę biodostępności i spożycia mikroelementów poprzez wzbogacanie lub suplementację żelazem, kwasem foliowym i innymi witaminami i minerałami.33

Interwencje dotyczące podstawowych przyczyn anemii obejmują kwestie takie jak:33

  • Kontrola chorób
  • Woda, warunki sanitarne i higiena
  • Zdrowie reprodukcyjne
  • Podstawowe przyczyny, takie jak ubóstwo, brak edukacji i normy płciowe

W niektórych regionach podejmowane są innowacyjne metody zapobiegania anemii, takie jak stosowanie olejów wzbogaconych mikroelementami. Badania wykazały, że codzienne stosowanie oleju wzbogaconego mikroelementami może znacznie zmniejszyć częstość występowania niedoboru żelaza u indyjskich dzieci z anemią w porównaniu z grupą placebo oraz prowadzi do znacznej poprawy poziomu witaminy B12 i kwasu foliowego u pozornie zdrowych indyjskich dzieci.34

Podsumowanie zaleceń profilaktycznych

Skuteczne zapobieganie anemii z niedoboru witamin wymaga kompleksowego podejścia:1635

  • Zróżnicowana dieta bogata w produkty zawierające witaminę B12, kwas foliowy, żelazo i inne niezbędne składniki odżywcze
  • Suplementacja u osób z grup ryzyka lub z potwierdzonymi niedoborami witamin
  • Regularne badania kontrolne pozwalające wykryć wczesne oznaki anemii z niedoboru witamin
  • Leczenie chorób podstawowych wpływających na wchłanianie witamin
  • Edukacja zdrowotna dotycząca znaczenia odpowiedniego odżywiania
  • Specjalne zalecenia dla szczególnych grup ryzyka, takich jak kobiety w ciąży, weganie, osoby starsze i pacjenci po operacjach bariatrycznych

Wczesne rozpoznanie i leczenie niedoborów witamin może zmniejszyć lub zapobiec powikłaniom związanym z niskim poziomem witamin, zwłaszcza witaminy B12 i kwasu foliowego.363738

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Mayo Clinic Health Library – Vitamin deficiency anemia | Swiss Medical Network
    https://www.swissmedical.net/it/healtcare-library/con-20212610
    Vitamin deficiency anemia can occur if you don’t eat enough foods containing vitamin B-12 and folate, or if your body has trouble absorbing or processing these vitamins. […] You can prevent some forms of vitamin deficiency anemia by choosing a healthy diet that includes a variety of foods. […] Most people get enough vitamins from the foods they eat. But if your diet is restricted or you’ve had gastric bypass surgery, you may wish to take a multivitamin.
  • #2 Nutritional-deficiency anemia: Causes, symptoms, and treatment
    https://www.medicalnewstoday.com/articles/188770
    Vitamin-deficiency anemia can develop when a persons diet contains too little vitamin B-12 or folate, which is vitamin B-9. The condition can also develop if the body is unable to absorb these vitamins effectively. It is most common in older people. […] To treat nutritional-deficiency anemia, a doctor will recommend having a varied diet that contains plenty of mineral-rich and fortified foods. They may also recommend supplements, if appropriate. […] Having a healthful and varied diet can usually provide enough nutrients to prevent anemia. […] If dietary changes do not improve a persons anemia, the doctor may recommend supplements. […] Doctors often prescribe iron and folic acid supplements during pregnancy. A healthcare professional can recommend specific dosages.
  • #3 Anemia – Vitamin B12–Deficiency Anemia | NHLBI, NIH
    https://www.nhlbi.nih.gov/health/anemia/vitamin-b12-deficiency-anemia
    If you are otherwise healthy, maintaining a normal diet enriched in vitamin B12 is important. […] Foods that are good sources of vitamin B12 include: […] Lean red meat and chicken […] Fish, such as catfish and salmon; and seafood, such as clams and oysters […] Milk, yogurt, cheese, and fortified vegan milk substitutes […] Fortified cereals […] Eggs.
  • #4 Vitamin Deficiency Anemia: Symptoms & Causes
    https://my.clevelandclinic.org/health/diseases/17732-vitamin-deficiency-anemia
    You can lower your risk of vitamin deficiency anemia by eating foods rich in vitamins B12 and B9. Foods high in B12 include: […] Your healthcare provider can guide you on how much vitamin B12 and B9 you need. They can also measure your current vitamin levels to check for deficiencies. If needed, your provider may prescribe a supplement.
  • #5 Vitamin B12 Deficiency: Symptoms, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/22831-vitamin-b12-deficiency
    Most people can prevent vitamin B12 deficiency by consuming foods and drinks that have vitamin B12. […] Options for consuming vitamin B12 include: […] Animal food products: Red meat, fish, poultry, eggs, milk and other dairy products all contain vitamin B12. […] Fortified foods: Fortified foods are foods that have certain vitamins and nutrients added to them that they dont naturally have. Fortified foods include certain breakfast cereals, nutritional yeast, plant milk and certain bread. Be sure to check the food label (nutritional facts) to see if the food has been fortified with vitamin B12. […] Vitamin B12 dietary supplements: Many multivitamins have vitamin B12. There are also supplements that only have vitamin B12. Ask your healthcare provider or pharmacist to help you choose which supplement is best for you.
  • #6
    https://www.who.int/news-room/fact-sheets/detail/anaemia
    Anaemia is preventable and treatable. […] There are many effective ways to treat and prevent anaemia. […] Changes in diet can help reduce anaemia in some cases, including: eating foods that are rich in iron, folate, vitamin B12, vitamin A, and other nutrients; eating a healthy diet with a variety of foods; taking supplements if a qualified health-care provider recommends them. […] Actions include: prevent and treat malaria; prevent and treat schistosomiasis and other infections caused by soil-transmitted helminths (parasitic worms); get vaccinated and practice good hygiene to prevent infections; manage chronic diseases like obesity and digestive problems; wait at least 24 months between pregnancies and use birth control to prevent unintended pregnancies; prevent and treat heavy menstrual bleeding and haemorrhage before or after birth; delay umbilical cord clamping after childbirth (not earlier than 1 minute); treat inherited red blood cell disorders like sickle-cell disease and thalassemia.
  • #7
    https://www.who.int/news-room/fact-sheets/detail/anaemia
    There are several ways to help prevent and manage anaemia in daily life, including eating a healthy and diverse diet and speaking to a health-care provider early if you have symptoms of anaemia. […] To keep a healthy and diverse diet: eat iron-rich foods, including lean red meats, fish and poultry, legumes (e.g. lentils and beans), fortified cereals and dark green leafy vegetables; eat foods rich in vitamin C (such as fruits and vegetables) which help the body absorb iron; and avoid foods that slow down iron absorption when consuming iron-rich foods, such as bran in cereals (wholewheat flour, oats), tea, coffee, cocoa and calcium. […] If you take calcium and iron supplements, take them at different times during the day.
  • #8 Anemia Information | Mount Sinai – New York
    https://www.mountsinai.org/health-library/condition/anemia
    Vitamin-deficiency anemia may result from not getting enough folic acid and vitamin B12 in your diet, or not being able to absorb these vitamins (due to celiac disease, for example); side effect of medication. […] Your doctor may suggest changes in your diet to make sure you get all the nutrients you need, such as vitamin B12, iron, and folic acid. […] Vitamin B12 helps in cases of vitamin deficient or pernicious anemia. Dietary sources include liver, meats, eggs, tuna, and cheese. People with pernicious anemia cannot absorb the proper amount of vitamin B12 and may need lifelong supplements. […] Folic acid can be taken for folic acid deficiency, which can cause anemia. Good food sources include green leafy vegetables, orange juice, and grains. Taking a folic acid supplement can hide a vitamin B12 deficiency, so always take vitamin B12 when taking folic acid. […] Pregnant women need more iron and folic acid than women who are not pregnant. A folic acid deficiency during pregnancy can cause a group of birth defects known as neural-tube defects, such as spina bifida.
  • #9 Iron deficiency anemia – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034
    You can reduce your risk of iron deficiency anemia by choosing iron-rich foods. […] Foods rich in iron include: […] You can enhance your body’s absorption of iron by drinking citrus juice or eating other foods rich in vitamin C at the same time that you eat high-iron foods. Vitamin C in citrus juices, like orange juice, helps your body to better absorb dietary iron. […] To prevent iron deficiency anemia in infants, feed your baby breast milk or iron-fortified formula for the first year. Cow’s milk isn’t a good source of iron for babies and isn’t recommended for infants under 1 year. After age 6 months, start feeding your baby iron-fortified cereals or pureed meats at least twice a day to boost iron intake. After one year, be sure children don’t drink more than 20 ounces (591 milliliters) of milk a day. Too much milk often takes the place of other foods, including those that are rich in iron.
  • #10 Vitamin B12 Deficiency: Recognition and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2017/0915/p384.html
    Vitamin B12 deficiency is a common cause of megaloblastic anemia, various neuropsychiatric symptoms, and other clinical manifestations. […] Screening may be warranted in patients with one or more risk factors, such as gastric or small intestine resections, inflammatory bowel disease, use of metformin for more than four months, use of proton pump inhibitors or histamine H2 blockers for more than 12 months, vegans or strict vegetarians, and adults older than 75 years. […] Absorption rates improve with supplementation; therefore, patients older than 50 years and vegans or strict vegetarians should consume foods fortified with vitamin B12 or take vitamin B12 supplements. […] Patients who have had bariatric surgery should receive 1 mg of oral vitamin B12 per day indefinitely. […] Because of potential interactions from prolonged medication use, physicians should consider screening patients for vitamin B12 deficiency if they have been taking proton pump inhibitors or H2 blockers for more than 12 months, or metformin for more than four months.
  • #11 Vitamin B12 Deficiency: Recognition and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2017/0915/p384.html
    Patients older than 50 years may not be able to adequately absorb dietary vitamin B12 and should consume food fortified with vitamin B12. […] Vegans and strict vegetarians should be counseled to consume fortified cereals or supplements to prevent deficiency. […] The American Society for Metabolic and Bariatric Surgery recommends that patients who have had bariatric surgery take 1 mg of oral vitamin B12 per day indefinitely.
  • #12 Diagnosis, Treatment and Long-Term Management of Vitamin B12 Deficiency in Adults: A Delphi Expert Consensus
    https://www.mdpi.com/2077-0383/13/8/2176
    Vitamin B12 deficiency can cause variable symptoms, which may be irreversible if not diagnosed and treated in a timely manner. […] Prophylactic B12 supplementation should be considered for specific high-risk groups. […] The panelists agreed that the prophylactic use of vitamin B12 was regarded as necessary for people diagnosed with atrophic gastritis, those with previous bariatric surgery, people at risk of B12 deficiency due to illnesses or medications, people with low or no consumption of animal source foods, and people ever diagnosed with vitamin B12 deficiency when they decided to become pregnant. […] The detection and treatment of vitamin B12 deficiency during pregnancy, lactation, and infancy should receive high priority due to the otherwise serious impact on fetal and infant development. Moreover, prophylactic B12 supplementation should be used from prepregnancy until the end of the lactation period in women with previously diagnosed B12 deficiency or who are at risk of vitamin B12 deficiency due for instance to low dietary intake of B12.
  • #13 Please note the change to our email address as of July 2022:
    https://www.haiderian.co.uk/info.aspx?p=15
    Folic acid has several important functions. For example, it: […] works together with vitamin B12 to form healthy red blood cells. […] A lack of folic acid could lead to folate deficiency anaemia. […] Adults need 0.2mg of folic acid a day. […] Folic acid cannot be stored in the body, so you need it in your diet every day. […] However, if you are pregnant or thinking of trying to have a baby, take a 0.4mg (400 microgram) of folic acid supplement daily from the time you stop using contraception until the 12th week of pregnancy. This is to help prevent birth defects of the central nervous system, such as spina bifida, in your baby. […] If you have a family history of conditions like spina bifida (known as neural tube defects), you may need to take 5mg of folic acid each day until the 12th week of pregnancy.
  • #14 Please note the change to our email address as of July 2022:
    https://www.haiderian.co.uk/info.aspx?p=15
    The Department of Health recommends that folic acid supplements are taken by women who are pregnant or thinking of having a baby. […] Women who are not pregnant or planning for a baby should be able to get all the folate they need by eating a varied and balanced diet. […] Vitamin B12 has several important functions and is involved in: […] making red blood cells and keeping the nervous system healthy. […] A lack of vitamin B12 could lead to vitamin B12 deficiency anaemia. […] You should be able to get all the vitamin B12 you need by eating a varied and balanced diet. If you take vitamin B12 supplements, do not take too much because this could be harmful.
  • #15 Folic Acid Safety, Interactions, and Health Outcomes | Folic Acid | CDC
    https://www.cdc.gov/folic-acid/about/safety.html
    Women capable of becoming pregnant should get 400 micrograms of folic acid daily to help prevent neural tube defects. […] Getting 400 mcg of folic acid each day helps prevent some serious birth defects called neural tube defects (NTDs). […] The well-established effectiveness of folic acid in preventing NTDs has been shown through randomized controlled trials and food fortification programs. […] Taking 400 mcg of folic acid per day has not been shown to cause harm. […] Folic acid helps prevents this type of anemia.
  • #16 Folate Deficiency: Causes and Treatment | Doctor
    https://patient.info/doctor/folate-deficiency
    Prophylactic folic acid (400 micrograms daily) is recommended for all women planning a pregnancy. […] Women who have had a child with an NTD should take 5 mg folic acid daily before and during a subsequent pregnancy. […] The higher dose of 5 mg during pregnancy is also recommended for the following: […] For those patients receiving renal dialysis, the prophylactic dose suggested is 5 mg daily to weekly, depending on the diet and rate of haemolysis. […] Prevention of methotrexate-induced side-effects in rheumatic disease for an adult aged over 18 years: 5 mg once weekly. […] Folic acid fortification in flour is mandatory in the UK to prevent NTDs in babies. […] Fortification with folic acid has been shown to reduce the prevalence of NTDs in the countries where it has been implemented.
  • #17 Prevention of Iron Deficiency in Infants and Toddlers | AAFP
    https://www.aafp.org/pubs/afp/issues/2002/1001/p1217.html
    The primary prevention of iron deficiency anemia in infants and toddlers hinges on healthy feeding practices. In infants, the introduction of cow’s milk in the first year of life is the greatest dietary risk factor for the development of iron deficiency and iron deficiency anemia. Therefore, the strict avoidance of cow’s milk in the first 12 months of life is essential in preventing iron deficiency anemia. […] To prevent iron deficiency, another option is a daily oral iron supplement, using ferrous sulfate drops or infant vitamin drops with iron. Iron supplementation via drops or iron-fortified cereal should be continued throughout the period of breastfeeding. […] In the second year of life, cow’s milk continues to cause problems in maintaining iron stores, and its consumption should be limited to less than 24 oz per day, with some clinicians calling for a stricter limit of 16 oz per day. […] Other preventive measures for toddlers include encouraging a diversified diet rich in sources of iron and vitamin C, continuing use of cereals fortified with iron instead of more advertised cereals, avoiding excessive juice intake, and giving an iron-containing vitamin.
  • #18 Iron and iron deficiency | Better Health Channel
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/iron
    Preventing iron deficiency in babies, children and young people […] Some suggestions to prevent iron deficiency in babies less than 12 months old include: Have an iron-rich diet during pregnancy. Red meat is the best source of iron. Tests to check for anaemia should be conducted during pregnancy. If your doctor prescribes iron supplements, take them only according to instructions. Breastfeed your baby or choose iron-fortified infant formulas. Don’t give your baby cows milk or other fluids that may displace iron-rich solid foods before 12 months old. Don’t delay the introduction of solid foods. Start giving your baby pureed foods when they are around 6 months old. Fortified baby cereal made with iron-fortified infant formula or breastmilk is generally the first food to offer. This is because of its iron content, but also because its texture is easy to change. Introduce soft lumpy foods or mashed foods at around 7 months.
  • #19 Iron and iron deficiency | Better Health Channel
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/iron
    To prevent iron deficiency in toddlers and preschoolers: Include lean red meat in their diet 3 to 4 times a week. Offer meat alternatives such as dried beans, lentils, chickpeas, canned beans, poultry, fish, eggs and small amounts of nuts and nut pastes. These are important sources of iron in your child’s daily diet. If your family follows a vegan or vegetarian diet, you may need to seek advice from a dietitian to ensure you are meeting all your child’s dietary needs. Include vitamin C in their diet as this helps the body to absorb more iron. Make sure your child has plenty of foods rich in vitamin C like oranges, lemons, mandarins, berries, kiwifruit, tomatoes, cabbage, capsicum and broccoli. Encourage solid foods at mealtimes and take care that toddlers are not filling up on drinks between meals. Remember that chronic diarrhoea can deplete your child’s iron stores, while intestinal parasites such as worms can cause iron deficiency. See your doctor for prompt diagnosis and treatment. Fussy eaters may be at risk due to poor intake or lack of variety in the foods they eat. Seek advice from your dietitian, local doctor or child health nurse on how to manage a fussy eater.
  • #20 Iron and iron deficiency | Better Health Channel
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/iron
    To prevent iron deficiency in teenagers: Talk to your child about the importance of iron. Help them become informed enough to make their own responsible food choices. Encourage iron-rich foods and meals, such as iron-fortified breakfast cereals and breads, and serve meat, poultry or fish with the evening meal. Offer good sources of non-haem iron such as dried beans, lentils, peas, broccoli, spinach, beans, fortified cereals, breads and whole grains if your child wants to avoid red meat or become vegetarian. Vitamin C-rich foods should also be encouraged, such as fruits or vegetables with meals. Encourage only moderate amounts of tea and coffee, as these can interfere with iron absorption.
  • #21 Iron Deficiency Anemia Treatment & Management: Approach Considerations, Iron Therapy, Management of Hemorrhage
    https://emedicine.medscape.com/article/202333-treatment
    Certain populations are at sufficiently high risk for iron deficiency to warrant consideration for prophylactic iron therapy. These include pregnant women, women with menorrhagia, consumers of a strict vegetarian diet, infants, adolescent girls, and regular blood donors. […] Pregnant women have been given supplemental iron since World War II, often in the form of all-purpose capsules containing vitamins, calcium, and iron. If the patient is anemic (hemoglobin 11 g/dL), administer the iron at a different time of day than calcium because calcium inhibits iron absorption. […] The practice of routinely administering iron to pregnant females in affluent societies has been challenged. Nevertheless, providing prophylactic iron therapy during the last half of pregnancy continues to be advisable, except in settings where careful follow-up for anemia and methods for measurement of serum iron and ferritin are readily available.
  • #22 Iron Deficiency Anemia Treatment & Management: Approach Considerations, Iron Therapy, Management of Hemorrhage
    https://emedicine.medscape.com/article/202333-treatment
    Iron supplementation of the diet of infants is advocated. Premature infants require more iron supplementation than term infants. Infants weaned early and fed bovine milk require more iron because the higher concentration of calcium in cow milk inhibits absorption of iron. Usually, infants receive iron from fortified cereal. Additional iron is present in commercial milk formulas. […] Iron supplementation in populations living on a largely vegetarian diet is advisable because of the lower bioavailability of inorganic iron than heme iron. […] The addition of iron to basic foodstuffs in affluent nations where meat is an important part of the diet is of questionable value and may be harmful. The gene for familial hemochromatosis (HFe gene) is prevalent (8% of the US white population). Excess body iron is postulated to be important in the etiology of coronary artery disease, strokes, certain carcinomas, and neurodegenerative disorders because iron is important in free radical formation.
  • #23 Nutritional Anemia | Article | GLOWM
    https://www.glowm.com/article/heading/vol-8–maternal-medical-health-and-disorders-in-pregnancy–nutritional-anemia/id/413143
    Appropriate dietary advice should be given to all women regarding healthy eating. Appropriate surveillance and treatment should be given regarding endemic infections that may cause anemia (e.g. hookworm, malaria). […] Fortification of food with iron has met with a number of barriers. Fortified foods are often financially unavailable to the poorest segments of the population who have the greatest risk of micronutrient deficiencies. Food choices for fortification need to be chosen carefully in order to deliver greatest benefit to those individuals at highest risk. […] Because of the importance of adequate pre-pregnancy iron stores, WHO guidelines recommend once-weekly supplementation with 60 mg elemental iron and 2.8 mg folic acid in all non-pregnant women of reproductive age living in regions with a greater than 20% prevalence of anemia (most developing countries). This together with regular deworming has been shown to be effective in increasing iron stores, stabilizing Hb and reducing soil transmitted helminth infections over periods of several years.
  • #24 Nutritional Anemia | Article | GLOWM
    https://www.glowm.com/article/heading/vol-8–maternal-medical-health-and-disorders-in-pregnancy–nutritional-anemia/id/413143
    In countries where anemia prevalence is over 40%, WHO recommends daily elemental iron supplementation of 60 mg in pregnant women together with folic acid 0.4 mg. […] Routine supplementation with 15-30 mg/day of elemental iron is recommended in pregnancy in North America. […] Recommendations for universal iron supplementation have not resulted in a consistent reduction in the incidence of iron deficiency anemia in pregnancy. Intermittent supplementation (2-3 times a week on non-consecutive days) produced similar maternal and infant outcomes to daily supplementation. […] In a study in which 133 pregnant African women were injected with 5-ml iron dextran complex in each buttock at their first antenatal visit, 84% of the treated group showed an improvement in Hb level (mean rise 1.025 g/dL) compared with 56% of women in a control group (mean rise 0.26 g/dL).
  • #25 The prevalence and risk factors associated with Iron, vitamin B12 and folate deficiencies in pregnant women: A cross-sectional study in Mbeya, Tanzania | PLOS Global Public Health
    https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0001828
    Maternal nutrition is an important forecaster of infants and mothers health status in most developing countries. This study aimed at assessing the prevalence and associated risk factors of iron, vitamin B12, and folate deficiencies among pregnant women in Mbeya Tanzania. […] The prevalence of iron, folate, and vitamin B12 deficiencies among pregnant women in Mbeya was 37.8%, 24.0%, and 9.7% respectively. […] We recommend for public health interventions for the provision of vitamin B12 along with iron and folic acid supplementations, especially in pregnant women belong to low socio-economic status and limited knowledge of healthy diet. […] The World Health Organization (WHO) recommends daily oral iron and folic acid supplementation with 30mg to 60mg of elemental iron and 400g (0.4mg) of folic acid for pregnant women; however, vitamin B12 supplementation received little attention from public health perspectives.
  • #26 Pernicious Anemia Treatment & Management: Approach Considerations, Cobalamin Therapy, Blood Transfusions
    https://emedicine.medscape.com/article/204930-treatment
    Because an increased familial incidence of pernicious anemia exists, family members should be aware that they are at greater risk of developing this disease and should seek medical attention promptly if they develop anemia or mental and neurologic symptoms. […] Prophylactically treat patients with cobalamin when they have undergone total gastrectomy, bypass procedures for weight reduction, ileectomy, pancreatectomy, or when they have atrophic gastritis or chronic inflammatory disease of the ileum. […] Strict vegetarians should continue supplementary cobalamin, particularly during pregnancy and while nursing a newborn infant. […] Elderly people are at risk for developing pernicious anemia due to achlorhydria. Therefore, serum vitamin B12 levels should be checked. If their levels are low or if cobalamin deficiency is suspected, they should be treated with vitamin B12 supplementation.
  • #27 Metformin and reduced vitamin B12 levels: new advice for monitoring patients at risk – GOV.UK
    https://www.gov.uk/drug-safety-update/metformin-and-reduced-vitamin-b12-levels-new-advice-for-monitoring-patients-at-risk
    Decreased vitamin B12 levels, or vitamin B12 deficiency, is now considered to be a common side effect in patients on metformin treatment, especially in those receiving a higher dose or longer treatment duration and in those with existing risk factors. […] We also advise that periodic monitoring for patients with risk factors for vitamin B12 deficiency should be considered. […] The updated product information also includes new advice to healthcare professionals to test vitamin B12 levels in those presenting with anaemia or neuropathy and that periodic vitamin B12 monitoring should be considered in patients with risk factors for vitamin B12 deficiency.
  • #28 Nutrient Deficiencies — No Stomach For Cancer
    https://nostomachforcancer.org/after-diagnosis/life-without-a-stomach/special-concerns/nutrient-deficiencies/
    Nutritional anemias resulting from a vitamin B12, folate or iron deficiency are common in people who have had a gastrectomy. Anemia may not occur until close to a year or more after surgery but it is important for your healthcare provider to monitor levels of these nutrients. […] People who have had a total gastrectomy will need to supplement their diet with regular vitamin B12 injections. […] Therefore, people who have had a partial or complete gastrectomy need to supplement their diet with oral vitamin B12 or intramuscular or subcutaneous injections of vitamin B12. […] It is important to have your B12 levels monitored by your healthcare provider at baseline following surgery and then every 3 months until they are normalized. Ongoing monitoring of B12 levels should occur on a yearly basis.
  • #29 Vitamin B12 Deficiency: Symptoms, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/22831-vitamin-b12-deficiency
    Other things you can do to help prevent vitamin B12 deficiency include: […] Avoid alcohol: Frequent alcohol consumption can damage your digestive system and make it difficult for your body to absorb vitamin B12. […] Do your best to manage your digestive disease: If you have a digestive disease such as Crohns disease or celiac disease, be sure to follow your healthcare providers instructions to stay healthy.
  • #30 Nutrient Deficiencies — No Stomach For Cancer
    https://nostomachforcancer.org/after-diagnosis/life-without-a-stomach/special-concerns/nutrient-deficiencies/
    To maintain normal B12 levels, monthly 1,000 mcg injections are usually required for life. […] It is important to discuss with your health care provider as there may be individual cases were more or less supplementation is appropriate. […] If a folate deficiency is suspected, your health care provider should obtain a red blood cell (RBC) folate level (rather than serum folate) to determine if there is an actual folate deficiency. […] For this reason, it is important to talk about your folate deficiency concerns with your healthcare provider. […] Your health care provider will test your serum ferritin level to determine iron deficiency. If you are deficient, you may need oral iron supplementation. […] Adults are usually require a supplementation of 60 200 mg elemental iron daily. […] Taking iron supplements with foods rich in Vitamin C will also enhance absorption. […] It may also help to include iron rich foods in your diet.
  • #31 Vitamin B12 Deficiency Anemia: Symptoms, Causes, Treatments
    https://www.webmd.com/a-to-z-guides/vitamin-b12-deficiency-anemia
    You can prevent B12 deficiency by: […] Eating animal products, like meat, fish, eggs, and milk. […] Looking for foods fortified with vitamin B12. These could be breakfast cereals and breads, nutritional yeast, or milk made from plants. Check the labels to make sure B12 is included. […] Taking vitamin B12 supplements. B12 might be part of a multivitamin or a standalone supplement. Check the labels. […] Cutting down or eliminating alcohol. Too much alcohol can damage your digestive system, which makes it hard for your body to absorb B12. […] Not misusing nitrous oxide.
  • #32 Vitamin B12 Deficiency: Causes, Symptoms, and Treatment
    https://www.webmd.com/diet/vitamin-b12-deficiency-symptoms-causes
    Vitamin B12 deficiency due to diet is rare in the U.S. Most people can prevent it by eating enough meat, poultry, seafood, dairy products, and eggs. […] If you don’t eat animal products, or you have a medical condition that limits how well your body absorbs nutrients, you can take vitamin B12 in a supplement or eat plant-based foods fortified with B12. […] If you take vitamin B12 supplements, let your doctor know so they can tell you how much you need, and make sure they won’t affect any medicines you’re taking. […] Avoid drinking too much alcohol. Drinking heavily can make it harder for your body to absorb nutrients, including B12. Too much alcohol can also prevent you from getting enough calories. Men shouldn’t drink more than two drinks a day, and women shouldn’t drink more than one drink a day.
  • #33
    https://www.who.int/health-topics/anaemia
    WHO has guidance that covers all WHO Regions to help reduce the prevalence of anaemia through prevention and treatment. […] These guidelines aim to increase dietary diversity, improve infant feeding practices and improve the bioavailability and intake of micronutrients through fortification or supplementation with iron, folic acid and other vitamins and minerals. […] Interventions to address the underlying and basic causes of anaemia look at issues such as disease control, water, sanitation and hygiene, reproductive health and root causes such as poverty, lack of education and gender norms. […] Accelerating anaemia reduction: a comprehensive framework for action. […] This document is an output of a WHO cross-programme initiative aiming to improve the prevention, diagnosis and management of anaemia and thereby…
  • #34 Micronutrient fortified oil for prevention of anemia, vitamin B12 and folate deficiency in Indian infants
    https://www.thrasherresearch.org/grant/01630?lang=eng
    Nutritional anemia is prevalent in 59% of under-five Indian children with the highest prevalence in those under-two years and is associated with poor neurocognitive development and impaired immune function. […] Vitamin B12 and folate deficiency is reported in 63-65% of Indian children and contribute to nutritional anemia. […] Daily application of LMF oil can significantly reduce the prevalence of iron deficiency in Indian children with anemia as compared to placebo group; The intervention of LMF oil results in significant improvement in vitamin B12 and folate levels in apparently healthy Indian children. […] The intervention of LMF oil was evaluated in a community-based double-blind randomized controlled study in 444 healthy Indian infants where the study participants received either LMF oil or placebo oil throughout their infancy. […] Application of body oil in infants is an ancient practice in the Indian sub-continent and the said intervention, if proven successful, can have a public health impact in terms of reducing micronutrient deficiencies.
  • #35 Vitamin Deficiency Anemia: Symptoms, Causes and Treatments
    https://www.medicoverhospitals.in/diseases/vitamin-deficiency-anemia/
    Preventing vitamin deficiency anemia involves maintaining a balanced diet rich in essential vitamins and addressing any medical conditions that might impair vitamin absorption. […] A diet that includes a variety of fruits, vegetables, whole grains, and lean proteins can help prevent vitamin deficiencies. For individuals with dietary restrictions, such as vegans, fortified foods or supplements may be necessary. […] Regular check-ups with a healthcare provider can help detect early signs of vitamin deficiency anemia and other related conditions. Blood tests to monitor vitamin levels can be a part of routine health screenings. […] For those with chronic conditions that affect vitamin absorption, managing the underlying condition is crucial. This may involve regular consultations with healthcare providers and adherence to prescribed treatments.
  • #36 Vitamin B12 deficiency anemia: MedlinePlus Medical EncyclopediaLock
    https://medlineplus.gov/ency/article/000574.htm
    Eating a well-balanced diet can help ensure you get enough vitamin B12 from the foods you eat. However, it can’t prevent anemia in people with certain health conditions that prevent their body from using vitamin B12 properly. […] Shots of vitamin B12 can prevent anemia if you’ve had a surgery known to cause vitamin B12 deficiency. […] Early diagnosis and prompt treatment can reduce or prevent complications related to a low vitamin B12 level. […] There is no evidence that taking B12 supplements will prevent or treat dementia, Alzheimer disease, or other health conditions such as heart disease.
  • #37 Vitamin B12 Deficiency Anemia – UF Health
    https://ufhealth.org/conditions-and-treatments/vitamin-b12-deficiency-anemia
    You can prevent anemia caused by a lack of vitamin B12 by eating a well-balanced diet. […] Shots of vitamin B12 can prevent anemia if you’ve had a surgery known to cause vitamin B12 deficiency. […] Early diagnosis and prompt treatment can reduce or prevent complications related to a low vitamin B12 level.
  • #38 Vitamin B12 deficiency anemia Information | Mount Sinai – New York
    https://www.mountsinai.org/health-library/diseases-conditions/vitamin-b12-deficiency-anemia
    Eating a well-balanced diet can help ensure you get enough vitamin B12 from the foods you eat. However, it can’t prevent anemia in people with certain health conditions that prevent their body from using vitamin B12 properly. […] Shots of vitamin B12 can prevent anemia if you’ve had a surgery known to cause vitamin B12 deficiency. […] Early diagnosis and prompt treatment can reduce or prevent complications related to a low vitamin B12 level.