B12-deficiency anemia and folic deficiency
The doctor, during the examination should pay attention to the yellowing of the sclera of the eyes, to a slight yellowish shade of the skin. If such signs are found, the patient should be immediately referred for laboratory tests.
To begin with, the patient must pass the following tests:
General blood test. This will reduce the level of red blood cells, hemoglobin, platelets, neutrophils. The color index of blood exceeds one. In addition, there is macrocytosis, anisocytosis, poikilocytosis. In erythrocytes, you can find the body of Jolly and the Keboat ring.
The level of bilirubin increases. To detect this, it is necessary to donate blood to biochemical analysis. If the laboratory results correspond to the described parameters, the patient is necessarily directed to the delivery of a puncture of the spinal cord. The fact is that a similar picture can be observed not only with B12-deficiency anemia, but also against the background of leukemia, hemolytic, hypoplastic and aplastic anemia. If huge megacarcites and granulocytes are found in the bone marrow, this is a sign that allows confirming B12 deficiency anemia.
Be sure to determine whether a person has only B12-deficiency anemia, or it is accompanied by folic deficiency anemia. Therefore, the doctor should carefully approach the study of the patient’s medical history, to find out whether close blood relatives suffered from similar violations. Without conducting laboratory research, it will not be possible to manage. It should be noted that the doctor faces certain difficulties. It is very difficult to calculate with a high accuracy the amount of certain vitamins in the blood. Microbiological studies only provide approximate values. Information can be given by radioimmunological methods, but they are not available to all categories of citizens. So, in small cities, such diagnostics are very difficult.
Therefore, in order to diagnose a patient, it is recommended to pass urine for analysis to determine the level of methylmalonic acid in it. Against the background of B12-deficient anemia, the level of this acid in urine will be increased, and in case of folic acid deficiency anemia its values remain within the norm.
It is equally important to establish the causes of the development of B12-deficiency anemia. For this, the following techniques can be used: ultrasound of the liver and other internal organs, determination of the level of thyroid hormones, analysis of feces for helminthiasis, determination of antibodies to the internal factor of the Castle. Such a procedure as the FGD is aimed at examining the mucous membrane of the stomach and intestines. It allows to detect atrophic changes on the internal surface of these organs.
How to treat? / h2
If a patient has a lack of folic acid, then he is prescribed this drug in the form of tablets. The average daily dose varies between 5-15 mg. If the doctor is not sure that the patient has a deficiency of folic acid, then therapy should begin with the intake of vitamin B12. It is administered intramuscularly. To do the opposite is not possible, because provided that the patient lacks vitamin B12, the use of folic acid will only harm the health.
Principles of treatment of anemia with vitamin B12 deficit:
Elimination of the deficiency and replenishment of cyanocobalamin reserves.
vitamin B12 with prophylactic purpose.
Control of the patient’s condition during and after the treatment.
Therapy B12- deficiency anemia is arranged as follows:
Intramuscular injection of cyanocobalamin at a dosage of 500 mcg per day. Intramuscular introduction of oxycobalamin in a dosage of 1000 mcg every other day. In the development of funicular myelosis, the dose is increased to 1000 μg for vitamin B12. It is also necessary to supplement the treatment with 500 μg of adenosyl cobalamin. The drug is given in tablet form.
Iron preparations are prescribed in the event that there is a deficiency of this trace element.
Severe anemia requires transfusion of erythrocyte mass. It is indicated for such violations as: severe cerebral hypoxia, anemic encephalopathy, heart failure, anemic coma.
Be sure to focus on eliminating the causes that triggered the development of anemia. It is possible that the patient will need antiparasitic treatment, treatment of diseases of the digestive system. The operation is performed when cancer is detected.
Separately for the patient develop a dietary diet scheme that will make up for the deficiency of vitamin B12 in the body.
After 3-4 days from the start of therapy, repeated count of the number of reticulocytes. If there is a reticulocyte crisis, then the treatment scheme can be considered effective.
When it is possible to normalize blood indicators, the patient is transferred to supportive therapy. First, every week he is administered 500 micrograms of vitamin B12, then the same dosage of the vitamin is administered every 30 days. Once every 6 months, a patient is recommended a course of vitamin B12 for a period of 14-21 days.
In a day an adult should receive 3-5 μg of vitamin B12. Therefore, it is of great importance for the treatment and prevention of anemia to have a properly organized diet. Products that must be included in the diet: beef, pork and chicken liver, mackerel, rabbit meat, meat (pork and beef), cod, carp, chicken eggs, sour cream.
If you ignore the treatment of B12-deficiency anemia, then it threatens serious health problems. All organs and systems will suffer (brain, heart, digestive, hematopoietic system, etc.). The earlier the therapy is started, the more favorable the prognosis. More often deficiency of vitamin B12 is easy for eliminating with the help of medicamentous correction.
Introduction to intramuscular injections of cyanocobalamin has improved the prognosis for recovery. If you follow the diet and doctor’s recommendations for taking the drug for preventive purposes, then the symptoms of B12-deficiency anemia can never be recognized.
An unfavorable prognosis will be when the treatment begins too late, with severe anemia, with the development of symptoms from the nervous system. Also, it is not always possible to cope with the complications of anemia caused by genetic disorders.
Video: about vitamin B12 deficiency, “Live healthy” program: