B12 folic acid deficiency anemia is called blood pathology characterized by insufficient production of red blood cells (erythrocytes), decrease hemoglobin and failure of various organs (mucous membranes of the digestive tract and nervous system) due to lack of in the body of vitamins B9 and B12. Hypovitaminosis can occur jointly or separately from each other. Symptoms appear after a few months of the termination of intake of vitamins.
Vitamin B12 is an entire group of biologically active substances. It is called Castle external factor and stimulates hematopoiesis (blood formation) process. B12 is involved in protein metabolism, promotes the synthesis of hemoglobin (it carries oxygen to the cells) and reduces the level of triglycerides. Folic acid contribute to the growth and development of the body, is involved in DNA replication, reduces the risk of cancer and provides reproductive health of men and women.
The causes and mechanism of development
Development B12 folic acid deficiency anemia contribute to:
- A disadvantage in the diet of animal products (liver and other by-products, fish, meat, seafood), which is rich in vitamin B12.
- Veganism and vegetarianism.
- Shortage in foods rich in folic acid menu (green, citrus fruits, raw vegetables, honey, egg, bakery products from wheat flour, liver, yeast, beans).
- Malabsorption of vitamins in the intestine. Perhaps helminthiasis (diphyllobothriasis), goiter, of chronic inflammatory bowel disease (enteritis, tuberculosis), celiac disease, sprue, Crohn's disease.
- Chronic alcoholism.
- Anorexia nervosa.
- Surgery (bowel resection).
- Folic acid antagonists. These include oral contraceptives, barbiturates, and anticonvulsants.
- Long-term use of medications (antibiotics).
- Increased need for vitamins. The reasons can be hard physical labor and pregnancy.
- Amplification vitamins removal process B9 B12 and excreted. Observed in diseases of the liver (cirrhosis), chronic heart failure and dialysis (blood purification hardware).
- The presence of cancer.
- Irradiation.
- Severe somatic disorders (hemoblastosis, psoriasis).
- Congenital lack of certain enzymes.
The basis of vitamin A deficiency on the following processes:
- depletion of the depot;
- Insufficient dietary intake;
- increased demand;
- impaired absorption and assimilation of vitamins;
- enhanced their elimination.
Once ingested with food cobalamin is converted to the active form (dezoksiadenozilkobalamin or methylcobalamin). Lack of these compounds leads to disruption of the formation of erythrocytes in the bone marrow, hemoglobin, and to a lesser extent platelets and leukocytes.
megaloblasts amount increases in blood (precursors of mature blood cells). This large-sized immature cells which can not fully perform its functions. This leads to disruption of the transport of oxygen and carbon dioxide. Developing tissue hypoxia.
Signs and symptoms
The clinical picture consists of the symptoms of an acute shortage of folic acid and vitamin B12. The signs of this disease are:
- Pale skin jaundiced.
- Paleness of mucous.
- Tachycardia (frequent palpitations).
- Pain in the left chest in the heart area. The reason - anoxia infarction.
- Intolerance to heavy load. Due to insufficient supply of oxygen to the muscles.
- Dizziness.
- Recurrent syncope.
- The presence of flies in front of the eyes.
- Splenomegaly (enlargement of spleen). The reason - the blockage of small blood vessels megaloblasts.
- Symptoms of the digestive system (change of taste sensitivity, sore tongue, burning in the mouth, bleeding gums, pain in the stomach after eating, and redness of the tongue atrophy papillae, unstable stool, loss of appetite, heartburn, swelling).
- Signs of damage to the nervous system as a violation of skin sensitivity (often in the hands), imbalance, clumsiness movements, muscle atrophy, muscle weakness, insomnia, memory decline, irritability, psychosis, seizures, attention impairment and hallucinations.
- Weight loss.
- The pressure drop.
- Weakness.
Clinical manifestations are determined by the degree of reduction of red blood cells and hemoglobin concentration, and vitamins. Anemia during pregnancy can cause bleeding, miscarriage, fetal malnutrition, development congenital malformations of the nervous system, premature birth and delayed psychomotor development of the child after delivery.
Diagnostics
For diagnosis will need:
- patient survey.
- General and physical examination.
- pressure measurement, calculation of heart rate and respiration.
- Blood analysis. Identifies folic acid reduction, vitamin B12, hemoglobin, red blood cells of different shapes and sizes, hyperchromicity (increasing color index), the presence megaloblasts and decrease in total cell number blood.
- Biochemical research. It can detect deviation in the liver. Homocysteine, methylmalonic acid and serum bilirubin unbound iron can be increased.
- General blood analysis.
- Fecal on helminth eggs.
- Investigation of bone marrow puncture.
- Analysis myelograms. Reveals bone marrow hyperplasia and megaloblasts.
- Instrumental examinations (ultrasound, colonoscopy, FEGDS for inspection of the gastric mucosa, ECG).
Treatment
Regimen B12 folievodefitsitnoy anemia comprises:
- Adherence to a strict diet.
- The elimination of risk factors (smoking cessation, deworming, non-vegetarian, with the exception of alcoholic drinks menu, the treatment of existing diseases).
- Taking medicines. Assigned Folic acid in the form of tablets for 4-6 weeks and cyanocobalamin in solution form. Such formulations, and how Folacin Mamifol apply only when a lack of folic acid. They are contraindicated in cobalamin deficiency.
- Red blood cell transfusions. It requires b12 in severe deficiency anemia (hemoglobin less than 70 g / l).
Diet
When anemia is necessary to enrich the menu sources cobalamin and folate. Useful in animal products (liver, sea fish, seafood, beef, pork), spinach, wholemeal bread, lettuce, carrots raw, avocado, yeast dough and cheese.
