Materiały źródłowe

• #1

  https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/

  Vitamin B12 or B9 (commonly called folate) deficiency anaemia occurs when a lack of vitamin B12 or folate causes the body to produce abnormally large red blood cells that cannot function properly. […] It’s important for vitamin B12 or folate deficiency anaemia to be diagnosed and treated as soon as possible. […] Most cases of vitamin B12 and folate deficiency can be easily treated with injections or tablets to replace the missing vitamins. […] In some cases, improving your diet can help treat the condition and prevent it coming back.

• #2 Vitamin B12 & folate anaemia | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/nutritional/vitamin-b12-or-folate-deficiency-anaemia/

  Vitamin B12 or folate deficiency anaemia occurs when a lack of vitamin B12 or folate causes the body to produce abnormally large red blood cells that cant function properly. […] It’s important for vitamin B12 or folate deficiency anaemia to be diagnosed and treated as soon as possible because, although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible. […] Most cases of vitamin B12 and folate deficiency can be easily treated with injections or tablets to replace the missing vitamins. […] In some cases, improving your diet can help treat the condition and prevent it recurring. […] If you’re pregnant or trying to get pregnant, it’s recommended that you take a 400 microgram folic acid tablet every day until you’re 12 weeks pregnant. This will ensure that both you and your baby have enough folate and help your baby grow and develop.

• #3 Vitamin deficiency anemia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vitamin-deficiency-anemia/symptoms-causes/syc-20355025

  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.

• #4 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.

• #5

  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. […] 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.

• #6 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.

• #7 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.

• #8 Folate Deficiency: Symptoms, Causes & Prevention

  https://my.clevelandclinic.org/health/diseases/22198-folate-deficiency

  Folate deficiency can be prevented by eating a diet rich in foods that contain folate. […] The best way to prevent folate deficiency is to eat a healthy diet that includes foods that contain folate or folic acid. […] If you’re pregnant, you should take a folic acid supplement to make sure you’re getting enough folate each day.

• #9 Folate-deficiency anemia Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/folate-deficiency-anemia

  Folate-deficiency anemia is a decrease in red blood cells (anemia) due to a lack of folate. Folate is a type of B vitamin. It is also called folic acid. […] Folate (folic acid) is needed for red blood cells to form and grow. You can get folate by eating green leafy vegetables and liver. However, your body does not store folate in large amounts. So, you need to eat plenty of folate-rich foods to maintain normal levels of this vitamin. […] Folic acid is needed to help a baby in the womb grow properly. Too little folic acid during pregnancy may lead to birth defects in a baby. […] Eating plenty of folate-rich foods can help prevent this condition. […] Experts recommend that women take 400 to 800 micrograms (mcg) of folic acid every day before they get pregnant and through the first 3 months of their pregnancy.

• #10

  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. […] 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.

• #11 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 average-risk adults for vitamin B12 deficiency is not recommended. 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. […] Oral administration of high-dose vitamin B12 (1 to 2 mg daily) is as effective as intramuscular administration for correcting anemia and neurologic symptoms. […] 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.

• #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 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 average-risk adults for vitamin B12 deficiency is not recommended. 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. […] Oral administration of high-dose vitamin B12 (1 to 2 mg daily) is as effective as intramuscular administration for correcting anemia and neurologic symptoms. […] 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.

• #14 Vitamin B12 Deficiency: Recognition and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0915/p384.html

  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. […] 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.

• #15 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 average-risk adults for vitamin B12 deficiency is not recommended. 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. […] Oral administration of high-dose vitamin B12 (1 to 2 mg daily) is as effective as intramuscular administration for correcting anemia and neurologic symptoms. […] 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.

• #16 Vitamin B12 Deficiency: Recognition and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0915/p384.html

  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. […] 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.

• #17 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.

• #18

  https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/treatment/

  The treatment for vitamin B12 or folate deficiency anaemia depends on what’s causing the condition. Most people can be easily treated with injections or tablets to replace the missing vitamins. […] If your vitamin B12 deficiency is caused by a lack of the vitamin in your diet, you may be advised to take vitamin B12 tablets every day between meals. […] People who find it difficult to get enough vitamin B12 in their diets, such as those following a vegan diet, may need vitamin B12 tablets for life. […] 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. […] To treat folate deficiency anaemia, your GP will usually prescribe daily folic acid tablets to build up your folate levels.

• #19 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 average-risk adults for vitamin B12 deficiency is not recommended. 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. […] Oral administration of high-dose vitamin B12 (1 to 2 mg daily) is as effective as intramuscular administration for correcting anemia and neurologic symptoms. […] 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.

• #20 Folate Deficiency Treatment & Management: Approach Considerations, Prevention

  https://emedicine.medscape.com/article/200184-treatment

  The dosage of folic acid needed to prevent or reverse folic acid deficiency varies with the clinical circumstances, as follows: Folate-deficient megaloblastic anemia due to dietary insufficiency or antiepileptic drugs: 5 mg/day for 4 months. Malabsorption: Up to 15 mg/day for 4 months. Chronic hemolytic states and kidney dialysis: for prophylaxis, 5 mg daily to weekly, depending on the patient’s diet and rate of hemolysis. […] Patients whose folic acid deficiency is related to dietary factors should be counseled to include green vegetables and fruit in their diet. Prophylactic treatment of pregnant patients and patients with chronic hemolytic anemias can prevent folic acid deficiency due to the increased requirement for folate in these conditions. Because major teratogenic effects from folate deficiency occur 3-4 weeks after conception and many pregnancies are unplanned, women of reproductive age should ensure that they are receiving 400 g daily, in addition to consuming food with folate from a varied diet. The US Centers for Disease Control and Prevention (CDC) recommends that women who have had a pregnancy affected by a neural tube defect consume 4000 g of folic acid each day 1 month before becoming pregnant and through the first 3 months of pregnancy.

• #21 Folate Deficiency Treatment & Management: Approach Considerations, Prevention

  https://emedicine.medscape.com/article/200184-treatment

  The dosage of folic acid needed to prevent or reverse folic acid deficiency varies with the clinical circumstances, as follows: Folate-deficient megaloblastic anemia due to dietary insufficiency or antiepileptic drugs: 5 mg/day for 4 months. Malabsorption: Up to 15 mg/day for 4 months. Chronic hemolytic states and kidney dialysis: for prophylaxis, 5 mg daily to weekly, depending on the patient’s diet and rate of hemolysis. […] Patients whose folic acid deficiency is related to dietary factors should be counseled to include green vegetables and fruit in their diet. Prophylactic treatment of pregnant patients and patients with chronic hemolytic anemias can prevent folic acid deficiency due to the increased requirement for folate in these conditions. Because major teratogenic effects from folate deficiency occur 3-4 weeks after conception and many pregnancies are unplanned, women of reproductive age should ensure that they are receiving 400 g daily, in addition to consuming food with folate from a varied diet. The US Centers for Disease Control and Prevention (CDC) recommends that women who have had a pregnancy affected by a neural tube defect consume 4000 g of folic acid each day 1 month before becoming pregnant and through the first 3 months of pregnancy.

• #22 Folate Deficiency: Causes and Treatment | Doctor

  https://patient.info/doctor/folate-deficiency

  Folic acid fortification in flour is mandatory in the UK to prevent NTDs in babies. […] 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: Where either partner has an NTD or has already had a pregnancy affected by NTD. […] Family history of NTD. […] Anti-epileptic medication. […] Coeliac disease. […] Diabetes (type 1 or 2). […] Thalassaemia trait (5 mg daily until birth of the baby). […] Haemolytic anaemia, particularly thalassaemia or sickle cell anaemia (5-10 mg until birth of the baby). […] Women with a BMI 30 kg/m2. […] For those patients receiving renal dialysis, the prophylactic dose suggested is 5 mg daily to weekly, depending on the diet and rate of haemolysis.

• #23 Vitamin B12 & folate anaemia | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/nutritional/vitamin-b12-or-folate-deficiency-anaemia/

  Vitamin B12 or folate deficiency anaemia occurs when a lack of vitamin B12 or folate causes the body to produce abnormally large red blood cells that cant function properly. […] It’s important for vitamin B12 or folate deficiency anaemia to be diagnosed and treated as soon as possible because, although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible. […] Most cases of vitamin B12 and folate deficiency can be easily treated with injections or tablets to replace the missing vitamins. […] In some cases, improving your diet can help treat the condition and prevent it recurring. […] If you’re pregnant or trying to get pregnant, it’s recommended that you take a 400 microgram folic acid tablet every day until you’re 12 weeks pregnant. This will ensure that both you and your baby have enough folate and help your baby grow and develop.

• #24 Folate Deficiency: Causes and Treatment | Doctor

  https://patient.info/doctor/folate-deficiency

  Folic acid fortification in flour is mandatory in the UK to prevent NTDs in babies. […] 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: Where either partner has an NTD or has already had a pregnancy affected by NTD. […] Family history of NTD. […] Anti-epileptic medication. […] Coeliac disease. […] Diabetes (type 1 or 2). […] Thalassaemia trait (5 mg daily until birth of the baby). […] Haemolytic anaemia, particularly thalassaemia or sickle cell anaemia (5-10 mg until birth of the baby). […] Women with a BMI 30 kg/m2. […] For those patients receiving renal dialysis, the prophylactic dose suggested is 5 mg daily to weekly, depending on the diet and rate of haemolysis.

• #25 Folate Deficiency: Causes and Treatment | Doctor

  https://patient.info/doctor/folate-deficiency

  Folic acid fortification in flour is mandatory in the UK to prevent NTDs in babies. […] 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: Where either partner has an NTD or has already had a pregnancy affected by NTD. […] Family history of NTD. […] Anti-epileptic medication. […] Coeliac disease. […] Diabetes (type 1 or 2). […] Thalassaemia trait (5 mg daily until birth of the baby). […] Haemolytic anaemia, particularly thalassaemia or sickle cell anaemia (5-10 mg until birth of the baby). […] Women with a BMI 30 kg/m2. […] For those patients receiving renal dialysis, the prophylactic dose suggested is 5 mg daily to weekly, depending on the diet and rate of haemolysis.

• #26 Folate Deficiency: Causes and Treatment | Doctor

  https://patient.info/doctor/folate-deficiency

  Prevention of methotrexate-induced side-effects in rheumatic disease for an adult aged over 18 years: 5 mg once weekly. […] Prophylactic folic acid is also given in chronic haematological disorders where there is rapid cell turnover (haemolysis): 5 mg every 1-7 days for an adult, depending on underlying disease.

• #27 Vitamin B12 & folate anaemia | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/nutritional/vitamin-b12-or-folate-deficiency-anaemia/

  Vitamin B12 or folate deficiency anaemia occurs when a lack of vitamin B12 or folate causes the body to produce abnormally large red blood cells that cant function properly. […] It’s important for vitamin B12 or folate deficiency anaemia to be diagnosed and treated as soon as possible because, although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible. […] Most cases of vitamin B12 and folate deficiency can be easily treated with injections or tablets to replace the missing vitamins. […] In some cases, improving your diet can help treat the condition and prevent it recurring. […] If you’re pregnant or trying to get pregnant, it’s recommended that you take a 400 microgram folic acid tablet every day until you’re 12 weeks pregnant. This will ensure that both you and your baby have enough folate and help your baby grow and develop.

• #28 Folate Deficiency: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/folate-deficiency

  Folate deficiency can cause anemia. Anemia is a condition in which you have too few RBCs. Anemia can deprive your tissues of oxygen it needs because RBCs carry the oxygen. This may affect their function. […] Most people get enough folate from food. Many foods now have additional folate in the form of folic acid, a synthetic version of folate, to prevent deficiency. Nevertheless, supplements are recommended for women who may become pregnant. […] Folic acid is especially important in pregnancy. Folic acid can help prevent certain birth irregularities called neural tube defects in babies. […] All people of childbearing age should get enough folic acid. […] The recommended folate dose is 400 micrograms per day. People who may become pregnant should take a folate supplement. Folate is critical for normal fetal growth. […] People who take medications known to cause folate deficiency should take a supplement as well, but it’s important to check with a doctor first.

• #29 Folate Deficiency: Causes and Treatment | Doctor

  https://patient.info/doctor/folate-deficiency

  Folic acid fortification in flour is mandatory in the UK to prevent NTDs in babies. […] 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: Where either partner has an NTD or has already had a pregnancy affected by NTD. […] Family history of NTD. […] Anti-epileptic medication. […] Coeliac disease. […] Diabetes (type 1 or 2). […] Thalassaemia trait (5 mg daily until birth of the baby). […] Haemolytic anaemia, particularly thalassaemia or sickle cell anaemia (5-10 mg until birth of the baby). […] Women with a BMI 30 kg/m2. […] For those patients receiving renal dialysis, the prophylactic dose suggested is 5 mg daily to weekly, depending on the diet and rate of haemolysis.

• #30 Caring for Kids New to Canada – Folic Acid Deficiency

  https://kidsnewtocanada.ca/conditions/folic-acid

  Folic acid deficiency can lead to birth defects, megaloblastic anemia and depression. […] Asymptomatic children with folic acid deficiency can be treated using dietary sources. Children with a chronic deficiency or at high risk of developing one should receive a folic acid supplement. […] Folic acid supplementation combined with a multivitamin supplement in pregnancy has been associated with a decrease in specific birth defects. […] Asymptomatic children with folic acid deficiency can be managed with a diet rich in folate, or supplemented by a multivitamin with folic acid. Children with clinical folic acid deficiency and those at high risk should be treated with supplemental folic acid.

• #31 Vitamin B12 deficiency – Wikipedia

  https://en.wikipedia.org/wiki/Vitamin_B12_deficiency

  Vitamin B12 deficiency is preventable with supplements, which are recommended for pregnant vegetarians and vegans, and not harmful in others. […] Vitamin B12 deficiency can lead to anemia, neurologic, and digestive dysfunctions. […] Vitamin B12 deficiency is one of the main causes of anemia. […] Anemia is defined as a condition in which there are not enough red blood cells, as the tissues and organs of the body do not get enough oxygen. […] The presence of peripheral sensory-motor symptoms or subacute combined degeneration of spinal cord strongly suggests the presence of a B12 deficiency instead of folate deficiency. […] Vitamin B12 and folate status during pregnancy is associated with the increasing risk of low birth weight, preterm birth, insulin resistance and obesity in the offspring.

• #32 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 average-risk adults for vitamin B12 deficiency is not recommended. 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. […] Oral administration of high-dose vitamin B12 (1 to 2 mg daily) is as effective as intramuscular administration for correcting anemia and neurologic symptoms. […] 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.

• #33 Vitamin B12 deficiency – Wikipedia

  https://en.wikipedia.org/wiki/Vitamin_B12_deficiency

  Vitamin B12 deficiency in the US and the UK is estimated to occur in about 6 percent of those under the age of 60, and 20 percent of those over the age of 60. […] Vitamin B12 deficiency may accompany certain eating disorders or restrictive diets. […] Vitamin B12 deficiency can also be caused by inadequate dietary intake such as with the diets of vegetarians, and vegans, and in the malnourished. […] Vitamin B12 deficiency is common and occurs worldwide.

• #34 Vitamin B12 deficiency – Wikipedia

  https://en.wikipedia.org/wiki/Vitamin_B12_deficiency

  Vitamin B12 deficiency in the US and the UK is estimated to occur in about 6 percent of those under the age of 60, and 20 percent of those over the age of 60. […] Vitamin B12 deficiency may accompany certain eating disorders or restrictive diets. […] Vitamin B12 deficiency can also be caused by inadequate dietary intake such as with the diets of vegetarians, and vegans, and in the malnourished. […] Vitamin B12 deficiency is common and occurs worldwide.

• #35 Vitamin B12 Deficiency: Recognition and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0915/p384.html

  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. […] 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.

• #36 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.

• #37 Vitamin B12 deficiency – Wikipedia

  https://en.wikipedia.org/wiki/Vitamin_B12_deficiency

  Vitamin B12 deficiency in the US and the UK is estimated to occur in about 6 percent of those under the age of 60, and 20 percent of those over the age of 60. […] Vitamin B12 deficiency may accompany certain eating disorders or restrictive diets. […] Vitamin B12 deficiency can also be caused by inadequate dietary intake such as with the diets of vegetarians, and vegans, and in the malnourished. […] Vitamin B12 deficiency is common and occurs worldwide.

• #38 Vitamin B12 Deficiency: Signs, Causes and Treatments | Ada

  https://ada.com/conditions/vitamin-b12-deficiency/

  Vitamin B12 deficiency occurs when there are inadequate levels of the vitamin B12 in the body. This important vitamin is necessary for the production of red blood cells and the healthy functioning of the nervous system. […] A lack of vitamin B12 can cause anemia and other health problems. […] For many people, a balanced and varied diet provides all the vitamin B12 they need. […] Despite the availability of vitamin B12 in a balanced diet, deficiency is not all that uncommon, particularly among people over 50 years of age, premenopausal women and people who follow strict vegan diets. […] It is important that people making long-term dietary changes, for example becoming vegan, eat food products that have been fortified with vitamin B12 or take a supplement to reduce the risk of developing a deficiency.

• #39 Vitamin B12 Deficiency: Signs, Causes and Treatments | Ada

  https://ada.com/conditions/vitamin-b12-deficiency/

  While it may not be possible to prevent vitamin B12 deficiency in all cases, steps can be taken to reduce the likelihood of the condition developing. […] It is recommended that strict vegans (and sometimes vegetarians) and people over 50 include breads, cereals or other food products that have been fortified with vitamin B12 in their diet, and/or take a supplement.

• #40 Megaloblastic anaemia: Folic acid and vitamin B12 metabolism | Revista Médica del Hospital General de México

  https://www.elsevier.es/en-revista-revista-medica-del-hospital-general-325-articulo-megaloblastic-anaemia-folic-acid-vitamin-S0185106315000426

  In certain patients, cobalamin supplements should be considered as part of routine clinical practice. […] Strict vegetarians should receive between 2 and 6mcg/day of oral supplement. […] Patients with prior partial gastrectomy or gastric bypass surgery are at high risk for subclinical cobalamin deficiency or deficiency associated with impaired absorption of cobalamin. […] In the absence of well-designed studies investigating this topic, the benefit of routine administration of cobalamin supplements is unclear. […] Nitrous oxide is known to inactivate cobalamin. For this reason, untreated or undiagnosed clinical cobalamin in patients scheduled for surgery using nitrous oxide may present rapid neuropsychiatric deterioration. […] The aim of this review has been to outline the essential information needed for the correct management of patients with megaloblastic anaemia.

• #41 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.

• #42 Vitamin B12 Deficiency – Disorders of Nutrition – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/disorders-of-nutrition/vitamins/vitamin-b12-deficiency

  Vitamin B12 deficiency can occur in vegans who do not take supplements or as a result of an absorption disorder. […] Vitamin B12 (cobalamins), with folate, is necessary for the formation and maturation of red blood cells and the synthesis of DNA (deoxyribonucleic acid), which is the genetic material of cells. […] Because vitamin B12 is necessary for the formation of mature blood cells, deficiency of this vitamin can result in anemia. […] Vitamin B12 deficiency can cause nerve damage (neuropathy) even when no anemia develops. […] For infants of vegan mothers, starting vitamin B12 supplements immediately after birth helps prevent vitamin B12 deficiency.

• #43 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.

• #44 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 average-risk adults for vitamin B12 deficiency is not recommended. 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. […] Oral administration of high-dose vitamin B12 (1 to 2 mg daily) is as effective as intramuscular administration for correcting anemia and neurologic symptoms. […] 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.

• #45 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.

• #46 Vitamin B12 Deficiency: Recognition and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0915/p384.html

  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. […] 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.

• #47 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 risk of low vitamin B12 levels increases with higher metformin dose, longer treatment duration, and in patients with risk factors for vitamin B12 deficiency. […] consider periodic vitamin B12 monitoring in patients with risk factors for vitamin B12 deficiency (see list of risk factors in article). […] 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.

• #48 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 risk of low vitamin B12 levels increases with higher metformin dose, longer treatment duration, and in patients with risk factors for vitamin B12 deficiency. […] consider periodic vitamin B12 monitoring in patients with risk factors for vitamin B12 deficiency (see list of risk factors in article). […] 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.

• #49 Vitamin B12 Deficiency: Recognition and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0915/p384.html

  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. […] 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.

• #50 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 risk of low vitamin B12 levels increases with higher metformin dose, longer treatment duration, and in patients with risk factors for vitamin B12 deficiency. […] consider periodic vitamin B12 monitoring in patients with risk factors for vitamin B12 deficiency (see list of risk factors in article). […] 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.

• #51 Folate Deficiency: Causes and Treatment | Doctor

  https://patient.info/doctor/folate-deficiency

  Folic acid fortification in flour is mandatory in the UK to prevent NTDs in babies. […] 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: Where either partner has an NTD or has already had a pregnancy affected by NTD. […] Family history of NTD. […] Anti-epileptic medication. […] Coeliac disease. […] Diabetes (type 1 or 2). […] Thalassaemia trait (5 mg daily until birth of the baby). […] Haemolytic anaemia, particularly thalassaemia or sickle cell anaemia (5-10 mg until birth of the baby). […] Women with a BMI 30 kg/m2. […] For those patients receiving renal dialysis, the prophylactic dose suggested is 5 mg daily to weekly, depending on the diet and rate of haemolysis.

• #52 Folic Acid and Vitamin B12 Fortification of Flour: A Global Basic Food Security Requirement | Public Health Reviews | Full Text

  https://publichealthreviews.biomedcentral.com/articles/10.1007/BF03391603

  Folic acid is an essential water soluble B vitamin which has been used for decades in the prevention of folate deficiency anemia of pregnancy. […] Where fortification has been implemented and studied, it has led to dramatic increases in serum folate concentrations, reduction in neural tube defects, folate deficiency anemia, as well as the reduction in homocysteine concentrations and stroke mortality with no known risk. […] This review discusses the vital importance of mandatory flour fortification with folic acid and vitamin B12, for public health food security and as a challenge to the New Public Health in Europe and globally.

• #53 Folate deficiency – Wikipedia

  https://en.wikipedia.org/wiki/Folate_deficiency

  Folate deficiency, also known as vitamin B9 deficiency, is a low level of folate and derivatives in the body. This may result in megaloblastic anemia in which red blood cells become abnormally large, and folate deficiency anemia is the term given for this medical condition. […] Vitamin B12 deficiency must be ruled out, if left untreated, may cause irreversible neurological damage. […] Treatment may include dietary changes and folic acid supplements. Dietary changes including eating foods high in folate such as, fruits and green leafy vegetables can help. Prevention is recommended for pregnant women or those who are planning a pregnancy. […] When supplemented with 450 micrograms of folic acid per day, the risk of developing birth defects, specifically neural tube defects, is decreased. Supplementation to prevent birth defects is most effective one month prior to and during the first twelve weeks of pregnancy. […] Over 80 countries require folic acid fortification in some foods.

• #54 Folic Acid and Vitamin B12 Fortification of Flour: A Global Basic Food Security Requirement | Public Health Reviews | Full Text

  https://publichealthreviews.biomedcentral.com/articles/10.1007/BF03391603

  Folic acid is an essential water soluble B vitamin which has been used for decades in the prevention of folate deficiency anemia of pregnancy. […] Where fortification has been implemented and studied, it has led to dramatic increases in serum folate concentrations, reduction in neural tube defects, folate deficiency anemia, as well as the reduction in homocysteine concentrations and stroke mortality with no known risk. […] This review discusses the vital importance of mandatory flour fortification with folic acid and vitamin B12, for public health food security and as a challenge to the New Public Health in Europe and globally.

• #55 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 the recommended amount of folic acid does not delay detection of vitamin B12 deficiency. […] Early studies suggested that folic acid supplementation could mask the anemia of vitamin B12 deficiency and delay diagnosis. However, current laboratory tests can measure a person’s vitamin B12 status. This means that vitamin B12 deficiency can be readily detected and diagnosed. […] A recent study looked at anemia among people with vitamin B12 deficiency before and after folic acid fortification. This study found that folic acid fortification did not make it more likely for people to have undetected vitamin B12 deficiency.

• #56 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.

• #57 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 average-risk adults for vitamin B12 deficiency is not recommended. 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. […] Oral administration of high-dose vitamin B12 (1 to 2 mg daily) is as effective as intramuscular administration for correcting anemia and neurologic symptoms. […] 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.

• #58 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 average-risk adults for vitamin B12 deficiency is not recommended. 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. […] Oral administration of high-dose vitamin B12 (1 to 2 mg daily) is as effective as intramuscular administration for correcting anemia and neurologic symptoms. […] 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.

• #59 Megaloblastic anaemia: Folic acid and vitamin B12 metabolism | Revista Médica del Hospital General de México

  https://www.elsevier.es/en-revista-revista-medica-del-hospital-general-325-articulo-megaloblastic-anaemia-folic-acid-vitamin-S0185106315000426

  Megaloblastic anaemia: Folic acid and cobalamin are B-group vitamins that play an essential role in many cellular processes. Deficiency in one or both of these vitamins causes megaloblastic anaemia, a disease characterized by the presence of megaloblasts. […] An understanding of the metabolism of these vitamins will enable clinicians to make the best use and interpretation of laboratory studies and monitor therapeutic strategies, which consist mainly of administering supplements to restore body reserves. […] Before starting treatment for megaloblastic anaemia due to folic acid deficiency, it is important to ascertain the absence of concomitant cobalamin deficiency, and even to establish that cobalamin deficiency is not, in fact, the sole pathogenesis. […] As in the case of folate deficiency, cobalamin deficiency therapy should continue until blood levels return to normal, or the underlying condition is resolved.

• #60

  https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/treatment/

  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. […] If a vitamin B12 deficiency is not detected and treated, it could affect your nervous system.

• #61 Please note the change to our email address as of July 2022:

  https://www.haiderian.co.uk/info.aspx?p=15

  Iron B12/Folate Diet Advice […] 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. […] Taking doses of folic acid higher than 1mg can disguise vitamin B12 deficiency. […] 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.

• #62

  https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/

  Vitamin B12 or B9 (commonly called folate) deficiency anaemia occurs when a lack of vitamin B12 or folate causes the body to produce abnormally large red blood cells that cannot function properly. […] It’s important for vitamin B12 or folate deficiency anaemia to be diagnosed and treated as soon as possible. […] Most cases of vitamin B12 and folate deficiency can be easily treated with injections or tablets to replace the missing vitamins. […] In some cases, improving your diet can help treat the condition and prevent it coming back.

• #63 Vitamin B12 & folate anaemia | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/nutritional/vitamin-b12-or-folate-deficiency-anaemia/

  Vitamin B12 or folate deficiency anaemia occurs when a lack of vitamin B12 or folate causes the body to produce abnormally large red blood cells that cant function properly. […] It’s important for vitamin B12 or folate deficiency anaemia to be diagnosed and treated as soon as possible because, although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible. […] Most cases of vitamin B12 and folate deficiency can be easily treated with injections or tablets to replace the missing vitamins. […] In some cases, improving your diet can help treat the condition and prevent it recurring. […] If you’re pregnant or trying to get pregnant, it’s recommended that you take a 400 microgram folic acid tablet every day until you’re 12 weeks pregnant. This will ensure that both you and your baby have enough folate and help your baby grow and develop.

• #64 Treatment of vitamin B12 and folate deficiencies – UpToDate

  https://www.uptodate.com/contents/treatment-of-vitamin-b12-and-folate-deficiencies

  All individuals with documented vitamin B12 and/or folate deficiency should be treated, unless there is a strong reason not to do so (eg, palliative care setting or patient refusal). […] Prevention of vitamin B12 deficiency […] Prevention of folate deficiency. […] Vitamin B12 deficiency: Risk factors and approach to prevention.

• #65 Megaloblastic anaemia: Folic acid and vitamin B12 metabolism | Revista Médica del Hospital General de México

  https://www.elsevier.es/en-revista-revista-medica-del-hospital-general-325-articulo-megaloblastic-anaemia-folic-acid-vitamin-S0185106315000426

  Megaloblastic anaemia: Folic acid and cobalamin are B-group vitamins that play an essential role in many cellular processes. Deficiency in one or both of these vitamins causes megaloblastic anaemia, a disease characterized by the presence of megaloblasts. […] An understanding of the metabolism of these vitamins will enable clinicians to make the best use and interpretation of laboratory studies and monitor therapeutic strategies, which consist mainly of administering supplements to restore body reserves. […] Before starting treatment for megaloblastic anaemia due to folic acid deficiency, it is important to ascertain the absence of concomitant cobalamin deficiency, and even to establish that cobalamin deficiency is not, in fact, the sole pathogenesis. […] As in the case of folate deficiency, cobalamin deficiency therapy should continue until blood levels return to normal, or the underlying condition is resolved.

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