What are vitamin B12 deficiency and folate deficiency? — Vitamin B12 and folate (also called "folic acid" or "vitamin B9") are 2 different vitamins that your body needs to work normally. A "deficiency" means that your body does not have as much of something as it needs.
People can have vitamin B12 deficiency, folate deficiency, or both.
Why are vitamin B12 and folate important? — Your body needs vitamin B12 for many things. For example, you need vitamin B12 to make new blood cells, such as red blood cells, and for your nervous system to work normally.
Your body needs folate, too, to make new cells. Folate is especially important for people who are planning to get pregnant (or might get pregnant). That's because folate is needed for a baby to develop normally, especially during the first few weeks of pregnancy. Folate is needed for the spinal cord to develop correctly.
What causes vitamin B12 deficiency or folate deficiency? — People can get vitamin B12 or folate deficiency when:
They don't eat enough foods that have the vitamin in them – Folate is added to many grains and cereals, so most people get enough. People who eat a vegetarian diet, especially strict vegans, need to take extra vitamin B12. (Vitamin B12 is found in meats and animal products like eggs.)
They eat foods with vitamin B12 and folate, but their body can't absorb or use the vitamins normally – These things can happen with certain medical problems such as pernicious anemia, after weight loss surgery, or as a side effect of certain medicines. This is more common in the case of vitamin B12.
They have a condition that makes them need extra folate – Examples include certain types of anemia and skin diseases.
What are the symptoms of vitamin B12 deficiency and folate deficiency? — A deficiency of vitamin B12, folate, or both can cause low blood counts. Your doctor can check this by doing a blood test. A low blood count can affect 1 or more of the following:
Red blood cells – Doctors use the term "anemia" when a person has too few red blood cells. Anemia can cause headaches or trouble breathing, especially with exercise. It can also make you feel tired or weak.
White blood cells – A low white blood cell count can increase your risk of infection.
Platelets – A low platelet count might increase your risk of bleeding.
Vitamin B12 deficiency can also cause other symptoms related to the brain and nerves. They include:
Tingling or numbness in the hands or feet
Memory problems or trouble thinking clearly
Should I see a doctor or nurse? — Yes. You should see your doctor or nurse if you have any of the symptoms listed above.
Is there a test for vitamin B12 deficiency and folate deficiency? — Yes. Your doctor or nurse can do blood tests to check for deficiencies of these vitamins.
If you have vitamin B12 or folate deficiency, your doctor or nurse will want to know why. He or she might do other tests to find out if it's because of a medical condition.
How are vitamin B12 deficiency and folate deficiency treated? — Doctors treat vitamin B12 deficiency by giving people vitamin B12. It comes in the form of a shot or pills. You can talk to your doctor about which form is better for your situation.
Doctors treat folate deficiency by giving people folic acid. Folic acid is basically the same as folate, but in a form that can be put in supplements or added to foods. For treating folate deficiency, it comes as a pill. Anyone who is pregnant or planning to get pregnant should also make sure they are getting enough folic acid.
Your doctor or nurse will also treat the cause of your deficiency, if it can be treated.
Can vitamin B12 deficiency and folate deficiency be prevented? — Yes. You can lower your chances of getting vitamin B12 and folate deficiency by eating foods that have the vitamins in them:
Foods with vitamin B12 include any foods from animals, such as meat, fish, eggs, and milk. If you are a strict vegetarian or vegan and do not eat any meats, dairy foods, or eggs, you will not get enough vitamin B12 from your diet alone. To avoid getting vitamin B12 deficiency, you should take a daily vitamin B12 supplement.
Foods with folate include fruits and green leafy vegetables. Many grains, like bread and cereals, have folic acid added to them.
Many people who have had weight loss surgery cannot get enough of these vitamins, especially vitamin B12. If you have had weight loss surgery, talk to your doctor about what supplements you should take.
Vitamin supplements are pills, capsules, or liquids that have nutrients in them.
What if I want to get pregnant? — If you want to get pregnant, you should start taking a multivitamin at least 1 month before you start trying to get pregnant. Choose a multivitamin that has at least 400 micrograms of folic acid. If you need help choosing a multivitamin, your doctor or nurse can help.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 17169 Version 8.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.
New! No Prescription? No problem.
Affordable Online Care is here! Answer a few questions about your concern and receive a treatment plan in as little as 15 minutes, from a board-certified provider, 100% online.Learn more