Vit B12 and Folate deficiency

Question 1

Define Vit B12 and Folate deficiency

Answer 1

Common deficiency
Vit B12 under 258 if often seen as possible deficiency. Under 148 is definite
folate-

Question 2

Aetiology and risk factors of Vit B12 and Folate deficiency

Answer 2

B12-found in diet-meats, yeast, animal products -> vegetarians can be deficient
other causes are pernicious anaemia, alcohol, Crohns/coeliac, gastric surgery

Folate-found in leafy greans and meat
Reduce intake, alcoholic
Malabsorption-coeliac, Crohns, chronic diarrhoea
Drugs-Abx (trimethoprim)
Increase use-methotrexate, pregnancy

Question 3

Epidiemology of Vit B12 and Folate deficiency

Answer 3

B12-cause mostly nerve issues
Very common 39% of adults are at risk of b12 def
More common in developing countries
Pregnancy and vegans/vegeratians are at risk

folate-will cause megaloblastic anaemia
less common Thant b12-cause in veggies and more sources
Vegetarian not at risk
developing countries without fortified foods are more at risk
especially during pregnancy

Question 4

Signs and Sx of Vit B12 and Folate deficiency

Answer 4

B12-parasthesia, decrease sense
Over long time-ataxia, Romberg test +ve

less common: pallor, tiredness,petichae, Glossitis, angular stomatitis, cognitive issues (confusion screen)

folate-megaloblastic aneamia-
headache, fatigue, SOB, dizziness, pallor
loss of appetite and weight loss
Tachycardia
glossitis, angular stomatitis
petechiae
can cause heart failure signs (murmur, overload etc)

Question 5

Investigations of Vit B12 and Folate deficiency

Answer 5

Bloods-measure serum levels
B12< 148, folate low
MCV high, Hb low,

B12-measure for pernicious anemiae (AB.s)
peripheral blood smear-megalocytes, hypersegmented
Low reticulocyte (different between haemolytic anaemia)

always treat folate before b12 -folate might hide B12 deficiencies