Anemia B12 / Folate Deficiency
What Does It Mean?
Anemia due to B12 or folate deficiency occurs when there is an insufficient supply of these vitamins, leading to impaired red blood cell production and neurological dysfunction. Both nutrients are essential for DNA synthesis, methylation, and proper nervous system function.
Key Physiological Imbalances:
- Impaired Red Blood Cell Formation: Leads to macrocytic anemia with larger-than-normal RBCs.
- Elevated Homocysteine Levels: Increased cardiovascular and neurological risks.
- Neurological Impairment: Myelin sheath damage leading to neuropathy and cognitive issues.
- DNA Methylation Disruptions: Affects detoxification, neurotransmitter production, and gene expression.
How Did We Get There?
Root Causes:
- Inadequate dietary intake (vegan/vegetarian diets)
- Malabsorption disorders (pernicious anemia, celiac disease, SIBO)
- Chronic alcohol consumption impairing vitamin absorption
- Genetic polymorphisms affecting B12 and folate metabolism (MTHFR mutations)
- Increased demand during pregnancy or chronic illness
Signs & Symptoms:
- Fatigue and weakness
- Pale skin and shortness of breath
- Neurological symptoms (numbness, tingling, memory loss, depression)
- Glossitis (inflamed tongue) and mouth sores
- Poor wound healing and brittle nails
- Increased homocysteine levels contributing to cardiovascular risk
Diagnostic Criteria:
Diagnosis is based on clinical presentation and laboratory testing.
Lab Test Findings
| Lab Test | Expected Changes | Optimal Range |
| Hematocrit | Decreased | 40.00-48.00 % |
| Hemoglobin | Decreased | 13.50-14.50 g/dL |
| Homocysteine | Increased | 5.00-7.20 µmol/L |
| Iron, Total | Decreased | 85.00-130.00 µg/dL |
| Lactate Dehydrogenase (LDH) | Increased | 140.00-200.00 U/L |
| MCH | Increased | 28.00-31.90 pg |
| MCV | Increased | 82.00-89.90 fL |
| Neutrophil % | Decreased | 48.00-60.00 % |
| Reticulocyte % | Normal or Decreased | 0.70-2.80 % |
| RBC | Decreased | 4.20-4.90 Cells/µL |
| Uric Acid | Increased | 3.50-5.40 mg.dL |
| WBC | Normal or Decreased | 5.5-7.5 Cells/µL |
How Do We Treat It?
Treatment focuses on replenishing B12 and folate stores, improving absorption, and addressing underlying causes.
Supplement Protocol
| Supplement | Function | Dosage & Frequency |
| Vita B Methyl | Provides bioavailable B12 and methylated folate | 1 capsule without food, daily |
Additional Lifestyle Interventions:
- Increase B12-Rich Foods: Include grass-fed meats, wild-caught fish, and eggs.
- Boost Folate Intake: Consume leafy greens, lentils, and avocado.
- Improve Gut Health: Address malabsorption issues with probiotics and digestive enzymes.
- Limit Alcohol Intake: Reduces interference with B12 absorption.
- Assess Genetic Factors: Consider testing for MTHFR polymorphisms to tailor supplementation.