Vitamin Deficiency Anaemia: Causes, Symptoms, and Treatment

What Causes Vitamin Deficiency Anaemia?

Several factors can lead to vitamin deficiency anaemia, ranging from dietary choices to underlying health conditions. Understanding these causes helps you identify potential risk factors and take preventive measures.

• Insufficient dietary intake: Not consuming enough foods rich in vitamin B12 or folate can gradually deplete your body's stores.
• Malabsorption disorders: Conditions like pernicious anaemia, celiac disease, and Crohn's disease prevent proper vitamin absorption from your digestive tract.
• Autoimmune conditions: Your immune system may attack cells that help absorb vitamin B12, particularly in pernicious anaemia.
• Certain medications: Some medicines used for cancer treatment, epilepsy, or other conditions can interfere with vitamin absorption and metabolism.
• Heavy alcohol consumption: Excessive drinking impairs your body's ability to absorb and process folate effectively.
• Increased nutritional demands: Pregnancy, breastfeeding, and periods of rapid growth require higher vitamin levels.
• Chronic illnesses: Long-term digestive problems or previous gastrointestinal surgery can affect nutrient absorption.

How Vitamin Deficiency Affects the Body

When you have vitamin deficiency anaemia, your body struggles to produce adequate healthy red blood cells, which are essential for carrying oxygen throughout your system. This reduced oxygen delivery affects every organ and tissue, leading to the characteristic symptoms of fatigue and weakness that many people experience.

Vitamin B12 plays a crucial role beyond red blood cell production — it is essential for proper nerve function. A B12 deficiency can therefore cause neurological symptoms, including tingling sensations, numbness in your hands and feet, confusion, and even memory problems. Over time, inadequate oxygenation combined with nerve dysfunction can significantly impact your quality of life and overall health.

The process begins gradually, as your body initially uses stored vitamins to maintain normal function. However, once these reserves become depleted, symptoms develop progressively. Your red blood cells may become larger than normal but fewer in number, a condition called megaloblastic anaemia, which is characteristic of vitamin deficiency anaemia.

Common Symptoms of Vitamin Deficiency Anaemia

Physical Symptoms:
• Persistent fatigue and weakness that doesn't improve with rest
• Shortness of breath, especially during physical activity
• Pale skin, particularly noticeable in the face, inner eyelids, or nail beds
• Heart palpitations or rapid heartbeat
• Dizziness or lightheadedness when standing up
• Cold hands and feet due to poor circulation

Digestive and Oral Symptoms:
• Loss of appetite and unexplained weight loss
• Nausea and indigestion
• Diarrhoea or constipation
• Sore, red, or swollen tongue
• Mouth ulcers that heal slowly
• Strange taste in your mouth

Neurological symptoms (particularly with vitamin B12 deficiency):
• Numbness or tingling in hands and feet
• Balance problems and unsteady walking
• Memory problems and confusion
• Depression, irritability, or mood changes
• Vision problems or blurred sight
• Difficulty concentrating at work or school

How Is Vitamin Deficiency Anaemia Diagnosed?

Diagnosing vitamin deficiency anaemia involves a systematic approach that combines your medical history, physical examination, and specific laboratory tests. Your doctor will follow these steps:

1. Comprehensive Medical History Review: Your doctor will ask about your symptoms, dietary habits, medical conditions, medications, and family history. They'll particularly focus on vegetarian diets, gastrointestinal problems, or previous surgeries that might affect nutrient absorption.
2. Thorough Physical Examination: The examination includes checking for pale skin, examining your tongue and mouth for soreness or swelling, listening to your heart for irregular rhythms, and testing your reflexes and coordination for neurological changes.
3. Initial Blood Tests: A complete blood count (CBC) test is typically the first diagnostic tool used. This test measures your red blood cell count, haemoglobin levels, and cell size, helping identify the characteristic large red blood cells associated with vitamin deficiency anaemia.
4. Specialised Vitamin Level Testing: Direct measurement of vitamin B12 and folate levels in your blood provides definitive evidence of deficiency. These tests are crucial for determining which vitamin deficiency causes anaemia in your specific case.
5. Additional Confirmatory Tests: If needed, your doctor may order tests for homocysteine and methylmalonic acid levels, which become elevated in vitamin deficiencies. Iron studies might also be performed to rule out iron deficiency anaemia.

Diagnostic Tests to Identify Vitamin Deficiency Anaemia

Several specific tests help confirm vitamin deficiency anaemia and determine its underlying cause. Understanding these tests can help you prepare for your medical appointments and better interpret your results.

• Complete Blood Count (CBC Test): This fundamental test measures your red blood cell count, haemoglobin levels, and cell size, often showing larger-than-normal red blood cells in vitamin deficiency anaemia.
• Blood smear examination: Microscopic analysis, such as Peripheral Blood Smear Examination (PBS), reveals the characteristic large, abnormal red blood cells called megaloblasts.
• Serum vitamin B12 levels: Direct measurement of these vitamins in your bloodstream using tests such as the Vitamin B12 Test provides definitive evidence of deficiency.
• Iron studies test: These tests help distinguish vitamin deficiency anaemia from iron deficiency anaemia, as the treatments differ significantly.

• Homocysteine and methylmalonic acid levels: Tests such as the Homocysteine Reflex B12-Folate Serum or Methylmalonic Acid Quantitative Test (Serum) are used, as these substances become elevated when vitamin B12 deficiency is present.
• Intrinsic Factor Antibody (IFA) Serum Test: This test helps identify pernicious anaemia, an autoimmune condition affecting B12 absorption.

Depending on your symptoms and test results, additional tests may include endoscopy to examine your digestive system or genetic testing for inherited conditions affecting vitamin absorption.

Treatment Options for Vitamin Deficiency Anaemia

Treatment approaches vary depending on the severity of your deficiency and its underlying cause. For mild to moderate folate deficiency, oral folic acid supplements are typically effective. However, vitamin B12 deficiency often requires more intensive treatment, particularly when caused by malabsorption problems.

If you have a severe vitamin B12 deficiency or conditions affecting absorption, your doctor may recommend B12 injections initially. These bypass digestive absorption issues and rapidly restore your vitamin levels. Once your levels normalise, you may continue with regular injections or switch to high-dose oral supplements, depending on your specific situation.

Dietary modifications play an important supporting role in treatment. Including more vitamin-rich foods in your diet helps maintain adequate levels once supplementation corrects the deficiency. However, supplements remain necessary for many people, particularly those with absorption problems or dietary restrictions.

When to See a Doctor

Knowing when to seek medical attention for potential vitamin deficiency anaemia can prevent complications and ensure timely treatment. You should schedule a medical appointment if you experience persistent fatigue that doesn't improve with adequate rest and sleep. This is particularly important if fatigue occurs alongside other symptoms such as shortness of breath, heart palpitations, or noticeable paleness. These combinations often indicate anaemia requiring medical evaluation.

According to the NHS, neurological symptoms, especially tingling or numbness in your hands and feet, memory problems, confusion, or balance difficulties, should be promptly checked by your doctor. These symptoms may indicate a vitamin B12 deficiency affecting your nervous system, and early treatment can prevent permanent damage.

Certain groups face a higher risk of vitamin deficiency anaemia and should be particularly vigilant about symptoms. Older adults, people with digestive disorders, strict vegetarians, and pregnant women should discuss regular screening with their doctors. Early detection through routine blood tests can identify deficiencies before symptoms develop.

Conclusion

Vitamin deficiency anaemia is a manageable condition that responds well to appropriate treatment when diagnosed early. By understanding which vitamin deficiency causes anaemia (primarily B12 and folate deficiencies), you can take proactive steps to protect your health. The key lies in recognising symptoms, seeking timely medical evaluation, and following through with prescribed treatments.

At Metropolis Healthcare, we understand the importance of accurate diagnosis in managing vitamin deficiency anaemia. Our comprehensive portfolio of over 4,000 tests includes complete blood count (CBC) tests, iron studies, and vitamin level assessments essential for diagnosing this condition. With our extensive network of more than 220 laboratories and 4,600+ service centres, we bring reliable diagnostic services directly to your doorstep through convenient home sample collection.

FAQs

What is vitamin deficiency anaemia?

Vitamin deficiency anaemia occurs when your body cannot produce enough healthy red blood cells due to insufficient levels of vitamin B12 or folate, leading to reduced oxygen transport.

How can you prevent vitamin deficiency anaemia?

Prevention of vitamin deficiency anaemia involves:

• Eating a balanced diet rich in vitamin B12 and folate
• Taking supplements when necessary
• Limiting alcohol consumption
• Scheduling regular health checkups
• Managing underlying health conditions that affect nutrient absorption.

Can vitamin deficiency anaemia be cured?

Yes, vitamin deficiency anaemia is highly treatable and often completely reversible with appropriate vitamin supplementation and treatment of underlying causes when diagnosed early.

What foods can help with vitamin deficiency anaemia?

Foods that can help in vitamin deficiency anaemia are:

• Foods rich in vitamin B12: Meat, fish, eggs, milk, curd, paneer, cheese, and fortified breakfast cereals.
• Foods rich in folate: Spinach, methi, amaranth, broccoli, beans, chickpeas, lentils, sunflower seeds, whole grains, bananas
• Foods rich in vitamin C: Oranges, lemons, amla, tomatoes, kiwi, and guava.
• Foods rich in iron: Spinach, rajma, chana, masoor dal, dates, bajra, ragi, and fortified cereals.

Can vitamin deficiency anaemia cause permanent damage?

If left untreated, particularly B12 deficiency, it can lead to permanent nerve damage and cognitive problems, but most effects are reversible with prompt treatment.

References

• https://www.mayoclinic.org/diseases-conditions/vitamin-deficiency-anemia/symptoms-causes/syc-20355025
• https://my.clevelandclinic.org/health/diseases/17732-vitamin-deficiency-anemia#overview
• https://www.nhlbi.nih.gov/health/anemia/vitamin-b12-deficiency-anemia#What-causes-vitamin-B12%E2%80%93deficiency-anemia?
• https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/complications/
• https://medlineplus.gov/ency/article/000574.htm