Megaloblastic Anemia: Risks, Causes, Treatments, And Diagnoses

Megaloblastic anemia is known as a group of diseases whose origin is a deficiency in Vitamin B9 (folic acid or folate) or Vitamin B12 (cobalamin) or both. These vitamins are from the group known as water-soluble, are eliminated in the urine and are necessary for the formation of erythrocytes that provide oxygen to cells for normal functioning.

It is for this reason, that when there is a deficiency of one or both of them, the rate of DNA synthesis is lower, consequently the red blood cells increase in size, so the cells are destroyed.

The most common symptoms of megaloblastic anemia include

  • Pallor
  • Weightloss
  • Headache.
  • Exhausted.
  • Red, sore tongue (glossitis)
  • Muscle weakness.
  • Depression.
  • Difficulties with memory and / or comprehension.
  • Other disorders of neurological origin.

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How can it be diagnosed?

The doctor will see a complete medical history and evaluate the symptoms that may suggest a deficiency of either of the two, or both vitamins. It will probably indicate a complete hematology in which you can assess the mean corpuscular volume, MCV, a way to measure the size of red blood cells and mean corpuscular hemoglobin, or mean cellular hemoglobin HCM, which expresses the mass of hemoglobin that each blood cell contains Red; among other data. These blood tests, if the diagnosis is positive, will show a shortage of red blood cells and a size outside the normal (larger) of those that exist.

It will be possible to measure the levels of vitamin B12 and folic acid, in another component of blood, plasma. And they will be reduced, if you are dealing with megaloblastic anemia, in plasma and they will be reduced if they are the cause of megaloblastic anemia.

In some cases, a bone marrow biopsy may be necessary to confirm some results.

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Medical treatments

Early diagnosis and proper treatment will be decisive to overcome megaloblastic anemias. Likewise, changes in the diet and introduction of foods that contain Vitamin B 9 and Vitamin B 12, will promote recovery. These include meat, fish, seafood, vegetables in general and green leafy in particular, legumes and nuts.

In the event that anemia is caused by deficiencies in vitamin 12 supplementation or absorption, your doctor will probably order tablets or injections.

If the origin of the megaloblastic anemia is a pernicious anemia, the administration of cobalamin should be done for life and it will be necessary to evaluate the digestive functions periodically. If the source is folate deficiency, he will also prescribe vitamin supplements.

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Causes and consequences of suffering from it

Vitamin B12 deficiency can be due to an unbalanced diet or in which products that provide it (mainly meats) such as vegetarian diets are not included. Although it can also be due to difficulties in the body itself to absorb it, pancreatic diseases or intestinal infections.

Finally, a demand higher than normal can also accuse your deficit. For example, pregnancy, tumors, hyperthyroidism or the use of certain medicines.

The lack of folic acid is usually in diets that do not contain it, but it occurs as a result of malnutrition and alcoholism. Its origin can also be in intestinal or liver diseases or in difficulties to absorb it. The ingestion of some medicines can affect that their absorption does not take place.

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How does it affect children, youth and adults?

Anemia due to vitamin B12 deficiency is more common in low-income and vegetarian populations , it can occur at any age. Pernicious anemia is more common in adulthood, in adults between 50 and 60 years of age, and rare in children. It is associated with pregnancy in 9 out of 10 cases and is more frequent in premature or full-term children, children of mothers who have suffered from it or poor nutrition, there is a tendency for these infants from 6 months to lack the quantity iron needed. In older adults and the elderly, folate deficiency generally occurs as a result of inadequate dietary intake. In general, the body stores very little folate (four to six months). Malnutrition and alcoholism are common causes of folate deficiency in old age.

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Effects and consequences during pregnancy

The iron reserve of a healthy woman of childbearing age is 300 mg. When you get pregnant you will need about 4 milligrams per day and a balanced diet will only provide half of the requirement.

That is why a supplement of iron, folic acid and Vitamin B12 is indicated for pregnant women. This minimizes risks to the health of the pregnant woman and the baby and avoids premature births and risks in general for both, even after delivery.

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Some types of megaloblastic anemia

There are three types of megaloblastic anemias: vitamin B12 deficiency, folic acid deficiency and other causes . Among other causes, consumption of some medicines, hereditary and refractory condition are indicated.

Normochromic macrocytic megaloblastic anemia

Megaloblastic anemias are a group of macrocytic, aregenerative anemias, whose origin lies in the defective synthesis of DNA in the nucleus of cells . This alteration of DNA synthesis is caused in 95% of cases to a deficiency of the vitamins necessary for its synthesis: cobalamin (vitamin B12) and folic acid.

Some cytotoxic drugs such as those used to treat cancer could lead to this type of anemias. In this type of anemias, the values ​​of the red cell indices, as well as the color are normal, but the amount of hemoglobin is decreased.

It is observed in when there have been acute hemorrhages in the short term, hemolytic anemia, aplastic and myeloptic anemia, anemias of endocrine or renal origin and anemia of chronic diseases (infectious, some types of cancer and systemic).

Hypochromic microcytic megaloblastic anemia

Hypochromic microcytic megaloblastic anemia is caused by iron deficiency (iron deficiency anemia) or when the patient has chronic blood loss (occult bleeding).

But they may also be due to the presence of other anemias such as sideroacréstica (due to deficit of iron utilization), sideroblastic anemia, anemia due to blockage or reserve of iron in the organs and tissues, hemochromatosis, idiopathic pulmonary hemosiderosis, due to hemoglobinopathies , due to delayed globin synthesis and thalassemia.

Refractory megaloblastic anemia

Also known as MDS myelodysplastic syndrome. It is a group of diseases with a delicate prognosis that appear as a result of the body not having adequate production of red blood cells.

The situation is complicated by the resistance of the body itself to the treatment. Its origin is not always identifiable. They can happen from exposure to cancer treatments and the population with the highest incidence are white men after the age of 60.

It is characterized by low defenses, extreme fatigue and red spots on the skin (petechiae) and the spleen can become enlarged, causing dyspnea, exhaustion after minimal efforts. Traditional treatments, such as iron supplements, are ineffective, so blood transfusions are used. When it becomes more severe, chemotherapy and stem cell therapies are used.

Responsive to thiamine

It is characterized by the presence of megaloblastic anemia, non-type 1 diabetes mellitus, and sensorineural deafness . The clinical manifestations of megaloblastic anemia can include tiredness, fatigue, headaches, pale skin, diarrhea, and numb limbs.

All three diseases are treated and the prognosis for deafness is usually not favorable. However, in early treatments, good expectations are presented. Hearing support and ongoing care are recommended to alleviate symptoms, as well as regular blood, glucose, eye, and cardiovascular system checks.

Due to vitamin b12 deficiency

Megaloblastic anemia is caused by vitamin B12 deficiency, which causes alteration in the production of red blood cells, their early destruction in the marrow and the life span of red blood cells.

The source par excellence of this vitamin is meat and the body reserve, if normal, can cover up to 4 years. The deficiency of vitamin B12, especially alters tissues such as the digestive tract and central nervous system.

ITS CAUSES FREQUENTLY INCLUDE:

  • Insufficient diet due to malnutrition, vegetarianism, veganism or alcoholism
  • Difficulties in the absorption of vitamin B12 in the digestive tract

NUTRITIONAL RECOMMENDATIONS

A diet deficient in vitamin B12 can be an isolated cause of megaloblastic anemia in malnourished people, those who suffer from alcoholism, vegetarians, the elderly or psychiatric patients. In infants, their deficiencies in consumption are usually due to strict breastfeeding and a vegetarian mother. Inefficient digestion is a cause of vitamin deficiency

B12, especially in the elderly. This last group of the population is of special care in the area, because with age there is a tendency for the absorption of vitamin B12 to be more difficult, which is why it is considered a population at risk. For this reason, adequate nutrition and vitamin supplements are essential, as well as medical controls.

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PROPER NUTRITION AND PROHIBITED FOODS

  • Meats, some fish, shellfish, green leafy vegetables, and beets are indicated.
  • The moderate consumption of dairy products rich in calories such as puddings, custard is suggested. The same happens with industrial pastries and snacks, whether they are sweet or salty.
  • The consumption of alcoholic beverages should be moderate.

Articles on other types of anemia

We leave you a list with the articles of the other types of anemia that we have created, to make it easier to find information:

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Kathie Sand always saw the world of beauty as the terrain on which to build her professional career, a goal that was clear to her when she was only 15 years old. Her great concern to expand knowledge led her to settle in Paris where she studied hand in hand with the best beauty professionals and with the most advanced techniques for skin care.

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