IDA & VITAMIN
B12 & FOLIC
Chest pain, fast heartbeat or shortness of breath.
Headache, dizziness or lightheadedness.
Cold hands and feet.
Inflammation or soreness of your tongue.
Blood loss. ( Sudden blood loss due to injury or some specific condition)
Lack of iron in your diet
Inability to absorb iron
Red blood cell size and color. With iron deficiency anemia, red blood cells are
smaller and paler in color than normal.
Hematocrit. This is the percentage of your blood volumemade up by red
bloodcells.Normal levels are generally between35.5 and 44.9 percent for
adult womenand 38.3 to 48.6 percent for adult men. Thesevalues may
change depending on your age.
Hemoglobin. Lower than normal hemoglobin levels indicate anemia. The
normal hemoglobinrange is generallydefinedas 13.2 to 16.6 grams (g) of
hemoglobin per deciliter (dL) of bloodfor men and 11.6 to 15 g/dL for women.
Ferritin.This protein helps store iron in your body, and a low level of ferritin
usuallyindicates a low level of stored iron
Heart problems. Iron deficiency anemia may lead to a rapid or irregular
Problems during pregnancy. In pregnant women, severe iron deficiency
anemia has been linked to premature birth and low birth weight.
Growth problems. In infants and children, severe iron deficiency can lead
to anemia as well as delayed growth and development.
Endoscopy. Doctors often check for bleeding from a hiatal hernia, an
ulcer or the stomach with the aid of endoscopy
Colonoscopy. To rule out lower intestinal sources of bleeding
Ultrasound. Women may also have a pelvic ultrasound to look for the
cause of excess menstrual bleeding, such as uterine fibroids.
(Take iron tablets on an empty stomach)
(Don’t take iron with antacids)
(Take iron tablets with vitamin C.)
Depending on the cause, iron deficiency anemia treatment may involve:
1. Medications, such as oral contraceptives to lighten heavy menstrual flow
2. Antibiotics and other medications to treat peptic ulcers
3. Surgery to remove a bleeding polyp, a tumor or a fibroid
VITAMIN B12 & FOLIC ACID
VitaminB12 or B9 (commonly called folate) deficiency anaemia occurs
when a lack of vitaminB12 or folate causes the body to produce
abnormally large red blood cells that cannot function properly.
There are a number of problems that can lead to a vitamin B12 or folate deficiency.
pernicious anaemia – where your immune system attacks healthy cells in your stomach,
preventing your body absorbing vitamin B12 from the food you eat; this is the most common
cause of vitamin B12 deficiency in the UK
a lack of these vitamins in your diet – this is uncommon, but can happen if you have a vegan
diet and do not take vitamin B12 supplements or eat foods fortified with vitamin B12 , follow a
fad diet or have a generally poor diet for a long time
medicine – certain medicines, including anticonvulsants and proton pump inhibitors (PPIs), can
affect how much of these vitamins your body absorbs
Both vitamin B12 deficiency and folate deficiency are more common in older people, affecting
around 1 in 10 people aged 75 or over and 1 in 20 people aged 65 to 74.
Signs & Symptoms
a lack of energy
pins and needles (paraesthesia)
a sore and red tongue
psychological problems, which may include depression and confusion
problems with memory, understanding and judgement
The number and appearance of red blood cells
The amount of vitaminB-12 and folate in the blood
The presence of antibodies to intrinsic factor, which indicates pernicious
Problems with the nervous system
pregnancy complications and birth defects
Adults with severe anaemia are also at risk of developing heart failure.
Most cases of vitamin B12 and folate deficiency can be easily treated with
injections or tablets to replace the missing vitamins.
VitaminB12 supplements are usually given by injection at first.
Then, depending on whether your B12 deficiency is related to your diet,
you’ll either require B12 tablets between meals or regular injections.
Folic acid tablets are used to restore folate levels. These usually need to be
taken for 4 months.
In some cases, improving your diet can help treat the condition and
prevent it coming back.
VitaminB12 is found in meat, fish, eggs, dairy products, yeast extract (such
as Marmite) and specially fortified foods.
The best sources of folate include green vegetables, such as broccoli,
brussels sprouts and peas.
Benz, E. (2017). Anemias, Red Cells, and the Essential Elements of Red Cell
Homeostasis. In E. Benz, Jr., N. Berliner, & F. Schiffman (Eds.), Anemia:
Pathophysiology, Diagnosis, and Management (pp. 1-13). Cambridge:
Cambridge University Press. doi:10.1017/9781108586900.002
Handout: Iron Deficiency Anemia – From the National Anemia Action