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24 / 02 / 2018
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Vitamin deficiency anemia



Vitamin deficiency anemia results from low or depleted levels of vitamin B 12 or folic acid (folate). If your body is deficient in certain key vitamins, you can develop anemia - a condition in which your blood is low on healthy red blood cells.

Red blood cells carry oxygen from your lungs to all parts of your body. Without enough healthy red blood cells in circulation, your body can't get the oxygen it needs to feel energized. To produce red blood cells, your body needs the mineral iron. It also needs regular intake of vitamins such as vitamin B-12, folate and vitamin C.

A diet lacking in these key nutrients can lead to anemia. An inability to absorb them in your intestines also can cause the condition. Anemia caused by an inability to absorb vitamin B-12 is called pernicious anemia.

Vitamin deficiencies also can lead to health problems other than anemia. But you can usually correct vitamin deficiencies with vitamin supplements and dietary changes.

Signs and symptoms

Anemia occurs in many types, but the main symptom of most anemia's is fatigue. That's true for vitamin deficiency anemias, which can also result in:

  • Pale skin

  • A rapid heartbeat

  • Shortness of breath

  • Loss of appetite

  • Diarrhea

  • Numbness or tingling in your hands and feet

In addition, vitamin B-12 deficiency can also result in:

  • Yellowing or darkening of your skin

  • Sore mouth or tongue

  • Yellow-blue colorblindness

  • Mental confusion or forgetfulness

Vitamin deficiencies usually develop slowly, over several months to years. Signs and symptoms may be subtle at first, but they increase as the deficiency worsens.


Blood consists of a liquid called plasma and three types of blood cells:

  • White blood cells. These blood cells fight infection.

  • Platelets. These blood cells help your blood clot after a cut.

  • Red blood cells (erythrocytes). These are the most abundant of the three types. They carry oxygen from your lungs, via your bloodstream, to your brain and the other organs and tissues. Your body needs a supply of oxygenated blood to function. Oxygenated blood helps give your body its energy and your skin a healthy glow.

All three types of blood cells are produced regularly in your bone marrow — a red, spongy material located within the cavities of many of your large bones. To produce adequate numbers of healthy blood cells, especially red blood cells, your bone marrow needs a steady supply of iron, vitamin B-12, folate and vitamin C from your diet.

You need iron because red blood cells contain hemoglobin — an iron-rich substance that enables them to carry oxygen. Vitamin B-12 and folate are necessary because they're building blocks of red blood cells. Vitamin C aids in the formation of red blood cells by helping you absorb iron.

With a shortage of iron, your bone marrow produces fewer and smaller red blood cells. Anemia caused by a lack of vitamin C causes the bone marrow to make smaller red blood cells. Without enough vitamin B-12 or folate, your bone marrow produces large and underdeveloped red blood cells called megaloblasts. The result is a shortage of healthy red blood cells — anemia.

Anemia caused by a lack of iron is called iron deficiency anemia. Causes of vitamin deficiency anemias, also known as megaloblastic anemias, include:

  • Folate deficiency anemia. Folate, also known as vitamin B-9, is a nutrient found mainly in fresh fruits and leafy green vegetables. A diet consistently lacking in these foods can lead to a deficiency. An inability to absorb folate from food also can lead to a deficiency. Most nutrients from food are absorbed in your small intestine. People with diseases of the small intestine, such as Crohn's disease or celiac disease, or those who have had a large part of their small intestine surgically removed or bypassed may have difficulty absorbing folate or its synthetic form, folic acid. Alcohol decreases absorption of folate, so drinking alcohol to excess may lead to a deficiency. Certain prescription drugs, such as some antiseizure medications, can interfere with absorption of this nutrient. Pregnant women and women who are breast-feeding have an increased demand for folate, as do people undergoing hemodialysis for kidney disease. Failure to meet this increased demand can result in a deficiency. Your body stores some folate, but anemia can develop within months if your body's reserves are depleted.

  • Vitamin B-12 deficiency anemia (pernicious anemia). Rarely, vitamin B-12 deficiency results from a diet lacking in vitamin B-12, which is found mainly in meat, eggs and milk. Most often, a shortage occurs because your small intestine can't absorb vitamin B-12. This may be due to surgery to your stomach or small intestine, abnormal bacterial growth in your small intestine, or an intestinal disease, such as Crohn's disease or celiac disease, that interferes with the absorption of the vitamin. Vitamin B-12 deficiency can also be caused by a tapeworm ingested from contaminated fish, because the tapeworm saps nutrients from your body. However, a deficiency is most often due to a lack of a substance called intrinsic factor. Vitamin B-12 is broken down from food in your stomach. Intrinsic factor is a protein secreted by the stomach that joins with vitamin B-12 in the stomach and then escorts it through the small intestine to be absorbed into your bloodstream. Without intrinsic factor, vitamin B-12 can't be absorbed and leaves the body as waste. Lack of intrinsic factor may be due to an autoimmune reaction, in which your immune system mistakenly attacks the stomach cells that produce intrinsic factor. Or it may be due to a genetic defect that suddenly halts production of the protein in your adult years. Vitamin B-12 deficiency ultimately leads to anemia. If the deficiency is from a lack of intrinsic factor, it's called pernicious anemia. Pernicious means deadly. Lack of intrinsic factor was often fatal before the availability of vitamin B-12 shots. Because vitamin B-12 is stored in large amounts in your liver, it may take several years before you develop signs of a deficiency.

  • Vitamin C deficiency anemia. A lack of vitamin C in your diet can cause this type of anemia. Your body needs vitamin C, found mainly in citrus fruits, to produce healthy blood cells. Vitamin C helps your body absorb iron, an important building block of red blood cells.

Certain drugs to treat cancer also can cause vitamin deficiencies.

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.

In no event will the be liable for any decision made or action taken in reliance upon the information provided through this web site.
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Dr. Eddy Bettermann M.D.

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