Vitamin B12 or folate deficiency anaemia

Vitamin B12 and folate perform several important functions in the body, including keeping the nervous system healthy.

A deficiency in either of these vitamins can cause a wide range of problems, including:

• extreme tiredness
• a lack of energy
• pins and needles
• a sore and red tongue
• mouth ulcers
• muscle weakness
• problems with your vision
• psychological problems, which can range from mild depression or anxiety to confusion and dementia
• problems with memory, understanding and judgement

Some of these problems can also happen if you have a deficiency in vitamin B12 or folate but do not have anaemia.

There are a number of problems that can lead to a vitamin B12 or folate deficiency.

These include:

• 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 restrictive 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.

Most cases of vitamin B12 and folate deficiency can be easily treated with injections or tablets to replace the missing vitamins.

Vitamin B12 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.

Treatments may last until your vitamin B12 levels have improved or you may need treatment for the rest of your life.

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.

Vitamin B12 is found in meat, fish, eggs, dairy products and specially fortified foods.

Good sources of folate include green vegetables, such as broccoli, brussels sprouts and peas.

Vitamin B12 or folate deficiency anaemia can cause a wide range of symptoms, including extreme tiredness, a sore red tongue and muscle weakness.

The main treatments for vitamin B12 and folate deficiency anaemia are vitamin injections or tablets.

Causes of vitamin B12 or folate deficiency anaemia include a problem with your immune system and a lack of vitamins in your diet.