Hence there was a need tostudy the relationship of folic acid and vitamin B12 deficiency in patients with iron deficiency anaemia in . ; 15(11) quiz. The vitamins folic acid and B serve as coenzymes in one-carbon metabolism. its specific link to vitamin B deficiency, but not folate deficiency, .. category preformed somewhat better on cognitive function tests than. Vitamin B12; cobalamin; folic acid; RBC folate These tests measure the concentration of folate and vitamin B12 in the serum or plasma (liquid.
A deficiency in either vitamin B12 or folate can lead to a form of anaemia characterised by the production of fewer, but larger, red cells macrocytic anaemia. A deficiency in folate can cause neural tube defects such as spina bifida in a growing fetus.
- Vitamin B12 And Folic Acid
B12 and folate deficiencies are most often caused by not getting enough of the vitamins through the diet or supplements, inadequate absorption, or by increased need as seen in pregnancy. How is the sample collected for testing? A blood sample is obtained by inserting a needle into a vein in the arm.
Vitamin B12 and folate - Lab Tests Online AU
Is any test preparation needed to ensure the quality of the sample? Fasting for hours before sample collection may be required.
Fasting is essential for serum folate as food prior to testing can influence the measured serum level. The Test How is it used?
Vitamin B12 and folate can be ordered to investigate the cause of macrocytic anaemia. Testing for vitamin B12 and folate may be used to help evaluate the nutritional status of a patient with signs of significant malnutrition or malabsorption. This may include those with alcoholism and those with disorders associated with malabsorption such as coeliac diseaseCrohn's disease and cystic fibrosis.
Vitamin B12 and folate testing may also be ordered to help diagnose the cause of mental or behavioural changes, especially in the elderly. In patients with known vitamin B12 and folate deficiencies, these tests may be used occasionally to help monitor the effectiveness of treatment. Either a serum or RBC folate test may be used to help detect a deficiency.
Some doctors feel that the RBC folate test is more clinically relevant than serum folate but there is not widespread agreement on this.
Vitamin B12 And Folic Acid | Dr. Schweikart
In general the laboratory where the test is ordered will provide the doctor with expert advice about which test is best to assist with obtaining accurate vitamin B12 and folate levels. When is it requested?Dangers of Vitamin B12 Deficiency
A high mean corpuscular volume MCV indicates that the red blood cells are enlarged. Sometimes the test is ordered as part of a pre- pregnancy health screen along with a range of other tests that may help the woman ensure she is in the best health for a pregnancy. This is often part of what is called a delirium screen, it happens mostly when elderly patients are admitted to hospital.
Vitamin B12 and folate
They may also be used when a patient has physical symptoms that suggest a B12 or folate deficiency, including dizziness, weakness, fatigue, or a sore mouth or tongue. When a patient has symptoms suggesting nerve damage or impairment, such as tingling, burning, or numbness in their hands or feet, a vitamin B12 test may be requested to look for vitamin B12 deficiency.
Vitamin B12 and folate levels may sometimes be requested when a patient shows signs of malnutrition or malabsorption or is known to have a disorder that affects nutrient absorption. When a breastfed infant has a vitamin B12 or folate deficiency, then the mother may also be tested to see if she has a deficiency that is affecting both her and her child.
The vitamin B12 and folate tests may be ordered for individuals being treated for malnutrition or a B12 or folate deficiency to evaluate the effectiveness of treatment.
What does the test result mean? The test results will indicate the presence of the deficiency, but they do not necessarily reflect the severity of the anaemia or neuropathy associated with the deficiency or its underlying cause. It is possible to have low B12 or folate levels on blood tests without any clinical problems. In the case of B12 measurements, this partly reflects a weakness in the standard B12 blood test also called serum cobalamin which does not directly measure whether there is an actual deficiency of active vitamin B12 in the cells of the body.
Insufficient intake The human body stores several years worth of vitamin B12 in the liver and it is readily available in the food supply, so a dietary deficiency of this vitamin should be rare in Australia. It may be seen sometimes with general malnutrition, and in vegans - those who do not consume any animal products including milk and eggs.
It may also be seen in children of vegans and breast-fed infants. Since they do not have the stores that adults have, deficiencies in children and infants tend to occur earlier. With the advent of fortified cereals, breads, and grain products, folate deficiency is genrally rare in Australia.
This effect is due, in part, to the requirement by MS for both folate and vitamin B S-adenosylmethionine also serves as the sole methyl donor for the central nervous system, which may explain associations between folate deficiency and vitamin B deficiency and cognitive impairment and mental illness 34.
One of the most devastating consequences of vitamin B deficiency is a classic neuropathy called combined degeneration of the spinal cord 5.
The mechanism by which vitamin B deficiency leads to this fatal demyelinating illness is unknown, but its specific link to vitamin B deficiency, but not folate deficiency, may provide a clue to the causal pathway. Another unique consequence of vitamin B deficiency relates to its role in the isomerization of L-methylmalonyl—coenzyme A CoA to succinyl-CoA—a reaction that, unlike the remethylation of homocysteine, occurs in the mitochondria and does not involve folate.
Thus, vitamin B deficiency specifically results in increased methylmalonic acid MMA concentrations in both plasma and urine. Pernicious anemia and excessive intake of folic acid After studying malnourished pregnant women in India in the late s, Lucy Wills described a macrocytic anemia that shared some features with the blood abnormalities of elderly Europeans with pernicious anemia 6.
How do vitamin B12 and folic acid interact with each other?
For example, the cytologic properties of the 2 anemias were identical, and both types responded well to crude liver extract. However, only the tropical illness responded to yeast extract.
Furthermore, although purified liver extract had proved effective in the treatment of pernicious anemia, it did not cure the tropical form 6. This hypothesis was subsequently verified. However, the identification of vitamin B as the anti—pernicious anemia factor in liver 7 followed the isolation of folic acid from yeast 8 by several years, during which time folic acid was administered in large doses to patients with pernicious anemia 9.
Because the inappropriateness of this treatment quickly became apparent, reports of cases thus treated in the late s and early s comprise the entire body of literature on the effect of folic acid administration on persons deficient for vitamin B 10 — Reviews of the historic case reports allude to rapid neurologic deterioration after improvement of anemia 10 Consequently, the idea has developed that excessive intake of folic acid can obscure or mask vitamin B deficiency and potentially delay its diagnosis until neurologic consequences become irreversible Food folic acid fortification and the debate on folic acid safety The move by the United States and other governments to fortify staple food products with folic acid for the prevention of neural tube defects rekindled the debate over the safety of folic acid for the elderly, who are at high risk of vitamin B deficiency.
The high degree of uncertainty led some to question the safety of fortification 1920 and inspired others to criticize the upper intake as too conservative 21 Particularly in light of continued demands for a higher level of fortification 2324clearly defining the benefits and risks of high folic acid intake assumes vital importance.
Writing about this challenge, Moore 25 observed that the current fortification program provides the perfect opportunity for epidemiologic study of the unanswered questions, including those related to the interaction between folate and vitamin B