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Patient education: Vitamin B12 deficiency and folate deficiency (The Basics)

Patient education: Vitamin B12 deficiency and folate deficiency (The Basics)

What are vitamin B12 deficiency and folate deficiency? — Vitamin B12 and folate (also called "folic acid") are 2 different vitamins the body needs to work normally. A "deficiency" means that the body does not have as much of something as it needs.

People can have vitamin B12 deficiency, folate deficiency, or both.

Why are vitamin B12 and folate important? — The body needs vitamin B12 for many things. For example, it needs vitamin B12 to make new blood cells, such as red blood cells, white blood cells, and platelets. It also needs B12 for the nervous system to work normally.

The body also needs folate to make new cells. Folate is especially important for people who are planning to get pregnant (or might get pregnant). That's because folate is needed for a baby to develop normally, especially during the first few weeks of pregnancy. If a developing baby does not get enough folate, they can have a hole in their spine.

What causes vitamin B12 deficiency or folate deficiency? — People can get vitamin B12 or folate deficiency when:

They don't eat enough foods that have the vitamin in them – Folate is added to many grains and cereals, so most people get enough. People who eat a vegetarian diet, especially strict vegans, need to take extra vitamin B12. (Vitamin B12 is found in meats and animal products like eggs.)

They eat foods with vitamin B12 and folate, but their body can't absorb or use the vitamins normally – These things can happen with certain medical problems such as pernicious anemia, after weight loss surgery, or as a side effect of certain medicines. This is more common for vitamin B12.

They have a condition that makes them need extra folate – Examples include certain types of anemia and skin diseases.

What are the symptoms of vitamin B12 deficiency and folate deficiency? — A deficiency of vitamin B12, folate, or both can cause low blood counts. Your doctor can check this by doing a blood test. A low blood count can affect one or more of the following:

Red blood cells – When a person has too few red blood cells, it is called "anemia." It can cause headaches or trouble breathing, especially with exercise. It can also make you feel tired or weak.

White blood cells – A low white blood cell count can increase your risk of infection.

Platelets – A low platelet count might increase your risk of bleeding.

Vitamin B12 deficiency can also cause other symptoms related to the brain and nerves. They include:

Tingling or numbness in the hands or feet

Trouble walking

Mood changes

Memory problems or trouble thinking clearly

Folate deficiency during pregnancy can cause the fetus not to develop properly. The baby can be born with a hole in their back and spine.

Should I see a doctor or nurse? — Yes. See your doctor or nurse if you have any of the symptoms listed above.

Is there a test for vitamin B12 deficiency and folate deficiency? — Yes. Your doctor or nurse can do blood tests to check for these vitamin deficiencies.

If you have vitamin B12 or folate deficiency, your doctor or nurse will do tests to find out why. This might include other blood tests to find out if it is due to a medical condition.

How are vitamin B12 deficiency and folate deficiency treated? — Doctors treat vitamin B12 deficiency by giving vitamin B12. It comes as a shot or pills. Talk to your doctor about which form is better for your situation.

Doctors treat folate deficiency by giving folic acid. Folic acid is the form of folate in supplements or added to foods. It comes as a pill.

Your doctor or nurse will also treat the cause of your deficiency, if it can be treated.

Can vitamin B12 deficiency and folate deficiency be prevented? — Yes. You can lower your chances of getting these deficiencies by eating foods that have the vitamins in them:

Foods with vitamin B12 include any foods from animals, such as meat, fish, eggs, and milk. If you are a strict vegetarian or vegan and do not eat any meats, dairy foods, or eggs, you should take a vitamin B12 supplement.

Foods with folate include fruits and green, leafy vegetables. Many grains, like bread and cereals, have folic acid added to them.

Many people who had weight loss surgery cannot get enough of these vitamins, especially vitamin B12. Talk to your doctor about what supplements you should take.

What if I want to get pregnant? — Start taking a multivitamin with folic acid or folate at least 1 month before you start trying to get pregnant. Choose a multivitamin that has at least 400 micrograms of folic acid.

If you need help choosing a multivitamin, your doctor or nurse can help.

More on this topic

Patient education: Diet and health (The Basics)
Patient education: How to plan and prepare for a healthy pregnancy (The Basics)
Patient education: Health and nutrition during breastfeeding (The Basics)
Patient education: Nutrition before and during pregnancy (The Basics)
Patient education: Dementia (including Alzheimer disease) (The Basics)
Patient education: Vegetarian diet (The Basics)
Patient education: Anemia overview (The Basics)

Patient education: Diet and health (Beyond the Basics)
Patient education: Health and nutrition during breastfeeding (Beyond the Basics)
Patient education: Dementia (including Alzheimer disease) (Beyond the Basics)

This topic retrieved from UpToDate on: Jun 02, 2024.
Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms. 2024© UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
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