Definition and causes
Vitamin B12 and folic acid are important components in the formation of red blood cells, and admitted under normal circumstances in the intestine through what we eat. Vitamin B12 can be found only in animal foods and folic acid found in most fresh vegetables. The lack of consumption of these foods, or the inability to absorb vitamin B12 and folic acid in the gut, (see vitamin and mineralmangel ) Will include formed defective red blood cells, which can not transport oxygen, and the resulting anaemia (anaemia).
In industrialized countries play Monday, under normal circumstances, ample amounts of vitamin B12, if you eat meat. Vitamin B12 is stored in the liver, where most are stored up to 2-3 years' consumption. In the Nordic countries are the only ones who could get vitamin B12 deficiency, vegetarians, if one is being done not have an underlying illness.
Folic acid found in fresh vegetables but are destroyed by cooking. It is therefore important to take fresh fruit and vegetables, especially seen as a problem in the elderly and plejehjemsbeboere. Folinsyredepotet is small and Monday, after a week's lack of intake to experience symptoms of folinsyremangel. In the context of diseases in the upper part of the small intestine, for example. coeliac disease , Viewed the lack of removals of folic acid.
Intrinsic Factor, NS, is a protein formed in the kirtelceller in the stomach, which also produces gastric acid. For vitamin B12 can be included in the lower part of the small intestine, IF coupled with vitamin B12. Anaemia due to lack of formation of IF calledpernicious anaemia. The lack of production of the IF can be inherited.
In younger people due topernicious anaemiaThat the IF-producing kirtelceller in the stomach will be destroyed due to an error in the body's own immune system or errors in the DNA material. In older people due to pernicious anemia typically that there is a decline of kirtelcellerne due to old age. Approximately 1% of all over 70 years, pernicious anaemia.
Vitamin B12 and folinsyremangel will complicate the formation of DNA, necessary for the formation of all cells in the body, and therefore also affect other cells than the red blood cells. In particular, damage in the nervous tissues are feared, because this damage is irreversible. At the beginning of a pregnancy developing fetus nervous tissues quickly, and if the mother suffers from folinsyremangel, it can have disastrous consequences for foetal development.
The causes of anaemia due to lack of vitamin B12:
- Malnutrition is the leading cause globally.
- Pernicious anaemia is the commonest cause of the Nordic countries.
- Other causes of defective entry in the gut: surgical removal of parts of the small intestine ( Crohn's disease ) divertikler , Surgical removal of all or part of the stomach, bændelorme and inflammatory conditions in the small intestine.
The causes of anaemia due to lack of folic acid:
- Malnutrition inc. alcoholism .
- Increased consumption of folic acid, for example. during pregnancy and lactation hemolytic anemia .
- Reduced entry in the upper part of the small intestine in particular seen by surgical removal of the small intestine and impaired functioning of the pancreas.
- Disturbances in the metabolism caused by certain drugs.
Symptoms and fund
In addition to the general symptoms of anaemia , Will occur in the digestive symptoms in the form of:
- Taste disturbances.
- Tungesvien with inflammation of the tongue.
- Due. superficial in the intestinal tract looks nausea, vomiting, abdominal pain and sometimes diarrhea.
Serious symptoms of the nervous system can be expressed as:
- Sleeping, tingling and burning sensations on the skin.
- Lack of coordination.
- Psychiatric problems such as memory loss, confusion and possible. psychosis .
Precautions and diagnosis
If you have symptoms of anemia, it is important to be examined by a doctor. If you have symptoms of the nervous system, we must seek out a doctor as soon as possible. Is there a family member who is familiar with the pernicious anaemia, it should inform their doctor about this, so that they may be taken into account in the determination of anæmien.
If you are pregnant or thinking of becoming so, it is extremely important to make sure to take enough vitamin B12 and folic acid. In particular, folinsyremangel serious consequences for the fetus development in the first weeks of pregnancy when neural and lip-palate-column Can be seen in the worst cases.
The diagnosis made by taking a blood sample, which may include can measure the red cellular components containing folic acid. At a reduced amount of folic acid is due to the depleted warehouses. Looking at the blood under a microscope, the red blood cells be enlarged, if there is vitamin B12 deficiency. Mistænker Monday B12 vitamin deficiency, can be a Schillingstest to find out whether the shortage is due to reduced secretion of Intrinsic Factor from the stomach, or whether it is due to other causes.
Treatment of anaemia due to lack of vitamin B12 or folic acid
If B12 vitaminmanglen due to a reduced production of Intrinsic Factor, or have other optagelsesproblemer in the gut, you have to injection of vitamin B12 in a muscle. The treatment should be given life. When the body has been built up a tank, you must expect an injection every 3.-4. months.
Do we have excluded that folinsyremanglen due to lack of consumption of fresh fruit and vegetables, you can provide folinsyretilskud on prilled. Folinsyretilskud on a daily basis in 3-4 months and has good effect during 3-5 days. Pillebehandlingen also has good power, although the disease is due optagelsesproblemer in the gut. The chronic lack of folic acid, as evidenced by hæmolytiske anæmier , The treatment can be lifelong.
Select and complications
Generally the B12 vitaminindsprøjtning have good effect in a few days, and anæmien will recover gradually. Symptoms of the disturbance of the nervous system is harder to come by, and you can have problems with balance and coordination of movements for a long time. It is important to receive its B12 vitaminindsprøjtning every 3 .- 4. months, as anæmien and the symptoms will come back.
Folinsyrebehandlingen usually good prognosis. Is the reason for folinsyremangel not, the treatment can be lifelong.