Diagnosis and treatment of vitamin B12 and folic acid deficiency

Diagnosis and treatment of vitamin B12 and folic acid deficiency

Vitamin B12 and folic acid deficiencies are often considered together. These are two complex vitamins that the body requires for several important functions. They help in the blood cell formation, repairing of tissues and the synthesis of DNA. B12 also plays an important role in normal nerve cell formation.


What are Vitamin B12 and folic acid deficiencies?

These are nutrients that the body cannot produce but are essential for the body to function and stay healthy, therefore, they must be supplied through food or other supplements. A healthy body may have enough B12 to last many years but not enough folic acid. It is usually the following group of people that face deficiency of B12 and folic acid:

  •         The elderly
  •         Heavy alcohol drinkers
  •         Vegetarians and vegans
  •         Pregnant women who need these in increased amounts
  •         People with long-term use of medications


Slowly, with time , deficiency in either B12 or folic acid can lead to a condition in which the red blood cells are enlarged also known as macrocytic anemia. Such people are weak, light-headed and short on breath. A deficiency in B12 can also result in different degrees of neuropathy or nerve damage that causes a tingling and numbness in the person’s hands and feet. In extreme cases, the mental condition also gets affected causing irritation and confusion leading to dementia.

Therefore, it is a must to ensure that the body is fed with enough of these two.

To help you associate with the vitamin B12 and folic acid deficiencies, here are a few signs/ symptoms –

  •         Diarrhoea
  •         Dizziness
  •         Fatigue
  •         Loss of appetite
  •         Pale skin
  •         Increased heart rate/irregular heartbeats
  •         Shortness of breath
  •         Sore or smooth tongue and mouth
  •         A tingling sensation or numbness in the feet and hands
  •         Confusion or forgetfulness
  •         Paranoia


What causes B12 and folic acid deficiency?

There may be multiple reasons that can lead to B12 and or folic acid deficiencies.


  •         Insufficient dietary intake

When your mother constantly pesters you to take your food on time and to eat healthy, please listen.

B12 is found in animal products like red meat, fish, poultry, milk and eggs whereas folic acid also known as folate is found in all the greens (vegetables), citrus fruits, dry beans, yeast and vitamin fortified cereals. It is usually the people with poor nutrition or malnutrition who avoid consuming animal products that lead to the deficiency. So remember to eat your greens and your animal products without any fuss.

  •         Malabsorption

Vitamin B12 and folic acid deficiencies are common in people who have conditions that interfere in the absorption of vitamins in the small intestine. There are certain steps to the absorption of B12 by the small intestine so if a disease or condition interferes with this, then then the B12 absorption is impaired.

  •         Increased need for B12 and folic acid during-

Pregnancy, since there is increased cell and DNA synthesis. If a woman has a folic acid deficiency prior to pregnancy, it tends to increase during the pregnancy and can lead to premature birth thereby affecting the child.

People with cancer, also have an increased need for folate


  •         Other Causes

Heavy intake of alcohol causes this deficiency through a combination of poor nutrition. Some drugs can also lead to B12 deficiency. For instance, the diabetes drug metformin prevents B12 absorption.



Once the problem has been identified, it is now up to you to solve the problem and in the case of diseases proper medication and treatment is a must.

The ultimate treatment to B12 and folic acid deficiencies usually involves taking supplements that may be long term or life long, depending upon the cause. ‘People with conditions causing malabsorption need the B12 to be injected in them. While folic acid is given in the form of supplements.

It is advised that women who are of childbearing age should consider taking folic acid supplements. All pregnant women should take folic acid supplements to ensure safe and healthy fetal development thereby preventing neural tube defects.

Individuals with deficiency in both B12 and folic acid will need to take supplements containing both vitamins.

If a person with B12 deficiency only takes supplements for folic acid then the underlying neuropathy will still persist and vice versa. It is ideal to take supplements for both B12 and folic acid.

Back to blog