Vitamin deficiency anemia is a lack of healthy red blood cells caused when you have lower than normal amounts of certain vitamins. Vitamins linked to vitamin deficiency anemia include folate, vitamin B-12 and vitamin C.
Vitamin deficiency anemia can occur if you don't eat enough foods containing folate, vitamin B-12 or vitamin C, or it can occur if your body has trouble absorbing or processing these vitamins.
It's important to have your doctor diagnose and treat your anemia. Vitamin deficiency anemia can usually be corrected with vitamin supplements and changes to your diet.
Signs and symptoms of vitamin deficiency anemia include:
Vitamin deficiency usually develops slowly over several months to years. Vitamin deficiency signs and symptoms may be subtle at first, but they increase as the deficiency worsens.
Vitamin deficiency anemia develops when your body has a shortage of the vitamins needed to produce enough healthy red blood cells. Red blood cells carry oxygen from your lungs throughout your body.
If your diet is lacking in certain vitamins, vitamin deficiency anemia can develop. Or vitamin deficiency anemia may develop because your body can't properly absorb the nutrients from the foods you eat.
Causes of vitamin deficiency anemias include:
Folate, also known as vitamin B-9, is a nutrient found mainly in fruits and leafy green vegetables. A diet consistently lacking in these foods can lead to a deficiency.
Deficiency can also result if your body is unable to absorb folate from food. Most nutrients from food are absorbed in your small intestine. You might have difficulty absorbing folate or folic acid, the synthetic form of folate that's added to foods and supplements, if:
Pregnant women and women who are breast-feeding have an increased demand for folate, as do people undergoing dialysis for kidney disease. Failure to meet this increased demand can result in a deficiency.
Vitamin B-12 deficiency can result from a diet lacking in vitamin B-12, which is found mainly in meat, eggs and milk.
However, the most common cause of vitamin B-12 deficiency anemia is a lack of a substance called intrinsic factor, which can be caused when your immune system mistakenly attacks the stomach cells that produce this substance. This type of anemia is called pernicious anemia.
Intrinsic factor is a protein secreted by the stomach that joins vitamin B-12 in the stomach and moves it through the small intestine to be absorbed by your bloodstream. Without intrinsic factor, vitamin B-12 can't be absorbed and leaves your body as waste.
People with endocrine-related autoimmune disorders, such as diabetes or thyroid disease, may have an increased risk of developing pernicious anemia.
Vitamin B-12 deficiency anemia can also occur if your small intestine can't absorb vitamin B-12 for reasons other than a lack of intrinsic factor. This may happen if:
Vitamin C deficiency can develop if you don't get enough vitamin C from the foods you eat. Vitamin C deficiency is also possible if something impairs your ability to absorb vitamin C from food. For instance, smoking impairs your body's ability to absorb vitamin C.
Certain chronic illnesses, such as cancer or chronic kidney disease, also increase your risk of vitamin C deficiency anemia by affecting the absorption of vitamin C.
A number of factors can affect your body's vitamin stores. In general, your risk of vitamin deficiency is increased if:
Your diet contains little to no natural vitamin food sources, such as meat, dairy, fruits and vegetables. Vegetarians who don't eat dairy products and vegans, who don't eat any foods from animals, may fall into this category.
Consistently overcooking your food also can cause vitamin deficiency.
Being deficient in vitamins increases your risk of many health problems, including:
Pregnant women with folate deficiency may be more likely to experience complications, such as premature birth. A developing fetus that doesn't get enough folate from its mother can develop birth defects of the brain and spinal cord.
If you're thinking of becoming pregnant, ask your doctor whether you should consider taking folic acid supplements so that your body's stores of folate will be enough to support your baby.
While vitamin B-12 is important for the production of red blood cells, it's also important for a healthy nervous system.
Untreated, vitamin B-12 deficiency can lead to neurological problems, such as persistent tingling in your hands and feet or problems with balance. It can lead to mental confusion and forgetfulness because vitamin B-12 is necessary for healthy brain function.
Without treatment for vitamin B-12 deficiency, neurological complications can become permanent. Vitamin B-12 deficiency can cause these and other health problems before it leads to anemia.
Vitamin C deficiency can lead to scurvy. Signs and symptoms of this rare disease include bleeding under the skin and around the gums.
You can prevent some forms of vitamin deficiency anemias by choosing a healthy diet that includes a variety of foods.
Foods rich in folate include:
Foods rich in vitamin B-12 include:
Foods rich in vitamin C include:
Most adults need these daily dietary amounts of the following vitamins:
Pregnant and breast-feeding women may require more of each vitamin.
If you're concerned about getting enough vitamins from the food you eat, ask your doctor whether a multivitamin may be right for you. Most people get enough vitamins from the foods they eat. But if your diet is restricted, you may wish to take a multivitamin.
Smoking interferes with the absorption of nutrients, such as vitamin C, so it can raise your risk of a vitamin deficiency.
If you smoke, quit. If you don't smoke, don't start. If you've tried to quit on your own and haven't been successful, talk with your doctor about strategies to help you quit.
Alcohol can contribute to vitamin deficiency anemia. If you choose to drink alcohol, do so in moderation. For healthy adults, moderate drinking is generally considered to be:
A drink is 12 ounces (355 milliliters) of beer, 5 ounces (148 milliliters) of wine or 1.5 ounces (44 milliliters) of 80-proof distilled spirits.
Doctors diagnose vitamin deficiency anemias through blood tests that check:
The number and appearance of red blood cells. People with anemia have fewer red blood cells than normal.
In vitamin deficiency anemias related to a lack of vitamin B-12 and folate, the red blood cells appear large and underdeveloped. In advanced deficiencies, the numbers of white blood cells and platelets also might be decreased and look abnormal under a microscope.
If blood tests reveal a vitamin deficiency, your doctor may perform other tests to determine the type and cause, such as:
Treatment for vitamin deficiency anemia includes supplements and changes in diet.
Treatment involves eating a healthy diet and taking folic acid supplements as prescribed by your doctor. In most cases, folic acid supplements are taken orally.
Once your body's level of folate increases to normal, you may be able to stop taking the supplements. But if the cause of your folate deficiency can't be corrected, you may need to take folic acid supplements indefinitely.
Sometimes folate deficiency and B-12 deficiency occur at the same time. Treatment of the folate deficiency without treatment of the vitamin B-12 deficiency may make your symptoms worse.
If you have pernicious anemia, injections of vitamin B-12 are recommended for treatment. If you and your doctor consider your taking vitamin B-12 supplements orally, you'll need careful monitoring by your doctor.
If you have vitamin B-12 deficiency due to other causes, such as vitamin B-12 not being absorbed because of gastric bypass surgery, vitamin B-12 injections also are usually recommended.
At first, you may receive the shots as often as every other day. Eventually, you'll need injections just once a month, which may continue for life, depending on your situation.
For milder cases of vitamin B-12 deficiency, treatment may involve changes to your diet and vitamin B-12 supplements in pill form or as a nasal spray.
Treatment for anemia related to vitamin C deficiency is with vitamin C tablets. Additionally, you increase your intake of foods and beverages that contain vitamin C.
If you suspect that you have vitamin deficiency anemia, you're likely to start by seeing your family doctor or a general practitioner. However, in some cases, you may be referred to a doctor who specializes in treating blood disorders (hematologist).
Here's some information to help you get ready for your appointment and what to expect from your doctor.
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. For vitamin deficiency anemia, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment anytime that you don't understand something.
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to spend more time on. Your doctor may ask:
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