Vitamin B12 or folate deficiency anaemia

What is it?

Lack of vitamin B12 or B9 (folate) can cause a “macrocytic” anaemia where the bone marrow produces abnormally large red blood cells (macrocytes) which can’t function properly, for example when carrying oxygen round the body.

What are the symptoms? Extreme tiredness, paleness, lack of energy, pins and needles, sore and red tongue, mouth ulcers, muscle weakness, problems with your vision, psychological problems such as mild depression or anxiety, confusion and problems with memory, understanding and judgement.

What causes it?

■ Lack of B12 and B9 vitamins in your diet – it’s uncommon, but can happen with a vegan diet or a generally poor diet.

■ Medicines, including anticonvulsants and proton pump inhibitors (PPIs), can interfere with the absorption of these vitamins.

■ Pernicious anaemia – where your immune system attacks healthy cells in your stomach, preventing your body absorbing vitamin B12.

What’s the treatment?

Vitamin B12 and folate deficiency can be treated with injections or tablets to replace the lack of vitamins. Vitamin B12 is usually given by injection at first. Then if your B12 deficiency cannot be dealt with by diet, you’ll either require B12 tablets between meals or regular injections. Folic acid tablets taken for four months will restore folate levels.

Diet

Adjusting your diet will help treat the anaemia and prevent it coming back. Good sources of vitamin B12 are meat, fish, eggs, dairy products, yeast extract (such as Marmite) and specially fortified foods.

Green vegetables, such as broccoli, brussels sprouts and peas contain high levels of folate.