Vitamin B12 or folate deficiency anaemia - NHS
Introduction; B Vitamins and Heart Disease; Folate and Cancer; The Bottom Line: Getting . But the relationship between folate and cancer is a complicated one. Deficiencies of vitamin B12 and/or folate can cause megaloblastic anemia ( macrocytic Disorders affecting absorption in the small intestine . prevalence in a normal population and relationship to parietal cell autoantibody. Keywords: Deficiency, folate, folic acid, metabolism, vitamin B12 High levels of homocysteine are associated with heart disease, although .. anemia and neural tube defects, as mentioned above in relation to folic acid.
Six percent patients had neuropsychiatric manifestations. Posterior column involvement viz. In a small study, it was found that megaloblastic anemia may have symptoms and signs referable to several systems including hematology, dermatology, gastrointestinal, neurology, and neuropsychiatry.
Folic acid, hematological manifestations of folic acid deficiency, hematological manifestations of vitamin B12 deficiency, vitamin B12 Introduction Megaloblastic anemias are a heterogenous group of disorders that share common morphologic characteristics.
Erythrocytes are larger and have heavier nuclear-to-cytoplasmic ratios compared to normoblastic cells. Neutrophils can be hypersegmented, and megakaryocytes are abnormal.
On the molecular level in the megaloblastic cells, the maturation of nuclei is delayed while cytoplasmic development is normal. Megaloblastosis is a generalized disorder because non-hematopoietic cells such as GI and uterine cervical mucosal cells can also have megaloblastic features. The etiology of megaloblastic anemias is diverse, but a common basis is impaired DNA synthesis. The most common causes of megaloblastosis are cobalamin vitamin B12 and folate deficiencies.
The most well-known causes of cobalamin deficiency are pernicious anemia, failure of absorption of cobalamin in the terminal ileum, effects of medications e. The development of megaloblastic anemia is usually insidious; therefore, patients are often relatively asymptomatic because they have had time to adjust to the marked fall in hemoglobin levels.
There are a number of sporadic reports in the literature of compromised cellular immune status in patients with cobalamin and folate deficiencies affecting neutrophil functions. We hereby aim to find out the prevalence of these deficiencies in general population and correlate the findings with the symptomatology. Materials and Methods The present study is a cross-sectional observation study carried out on patients seeking medical attention on outpatient and inpatient basis in the medicine department of a teaching institute of Krishna Institute of Medical Sciences University, Karad.
Human body needs folic acid, especially those women who may get pregnant. Getting enough folic acid before and during pregnancy may prevent major birth defects of baby's brain or spine.
It is also known as vitamin B9, folate, or folic acid. All B vitamins help the body to convert the food carbohydrates into fuel glucosewhich is used to produce energy. These B vitamins, often referred to as B complex vitamins, help the body use fats and protein. B complex vitamins are needed for healthy skin, hair, eyes, and liver. Also, they help the nervous system function properly.
Folic acid is the synthetic form of B9 which is found in supplements and fortified foods, while folate occurs naturally in foods. It helps in the production of DNA and RNA, the body's genetic material, especially when cells and tissues are growing rapidly, such as during infancy, adolescence, and pregnancy.
Folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body. Vitamin B9 works with vitamins B6 and B12 and other nutrients in controlling the blood levels of the amino acid homocysteine. High levels of homocysteine are associated with heart disease, although some researchers are not sure whether homocysteine is a cause of heart disease or just a marker that indicates the presence of heart disease.
In addition, all grain and cereal products in the US are fortified with folic acid. These folic acid congeners are transported by receptor-mediated endocytosis across cells where they are needed to maintain normal erythropoiesis, interconvert amino acids, methylate tRNA, generate and use formate, and synthesize purine and thymidylate nucleic acids. Using vitamin B12 as a cofactor, folic acid can normalize high homocysteine levels by remethylation of homocysteine to methionine via methionine synthetase.
Since the body becomes deficient in folic acid, all cycles will become ineffective and lead to many problems such as megaloblastic anemia, cancer, and neural tube defects.
A Study of the Prevalence of Serum Vitamin B12 and Folic Acid Deficiency in Western Maharashtra
Urocanic acid is involved in many metabolic processes in order to generate formiminoglutamate which is known as "FIGLU" and is involved in generating glutamate with the help of formiminotransferase.
In folic acid deficiency, the catabolism of FIGLU is impaired and glutamate cannot be generated from formiminoglutamate; therefore, formiminoglutamate accumulates in the blood and is excreted in elevated amount in urine. Low glutamate level increases the likelihood of having schizophrenia, cognitive disorders, neuropsychiatric and anxiety disorders. Also, glutamate plays an important role in the body's disposal of excess or waste nitrogen.
Glutamate undergoes deamination, an oxidative reaction catalyzed by glutamate dehydrogenase. Some tissues are considered as glycine producers, while others, e. Both serine and glycine are transported across the mitochondrial membrane rapidly. Also, many processes inside the body are impaired, such as impaired function of RNA and DNA, fat and fatty acid metabolism, and muscle formation.
Low level of either serotonin or tryptophan has been linked to depression, confusion, insomnia, and anxiety.
The metabolic processes of folic acid and Vitamin B12 deficiency Mahmood L - J Health Res Rev
Moreover, low serine level leads to decreased performance of the immune system since serine is involved in antibody formation. It is involved as 5-methyl tetrahydrofolate methionine in the methylation process where the methyl group is transferred to homocysteine to form methionine in the presence of methionine synthase enzyme. Methionine synthase is one of the only two enzymes known to be Bdependent enzymes. This process depends on both folic acid as well as vitamin B This reaction needs ATP and vitamin B12 and also the presence of methionine adenosyl transferase [Figure 1].
Methionine is also known to be essential for the formation of collagen that is involved in the formation of skin, nails, and connective tissues, and low methionine level has negative effects in these processes and functions.
Thymidylate synthase is involved in catalyzing the transfer of formaldehyde from folate to dUMP in order to form dTMP. Thymidylate synthase It is an enzyme that plays a role in the replication of cells and tissues.
From this cycle, the role of folate can be linked to cancer. Thymidylate synthase is a metabolic poison that is involved in causing functional folate deficiency, and body's cells grow rapidly as a result of increase in DNA synthesis.
How do vitamin B12 and folic acid interact with each other?
Many anti-cancer drugs act indirectly by inhibiting DHFR or directly by inhibiting thymidylate synthase. Purine has many important roles in cell growth, division, and development, since it is considered to be along with the pyrimidine base of the DNA helix. In case of folate deficiency, there is an impairment of functions of purine, which means impairment in production of DNA, and leads to many problems inside the body, since DNA is the basis of every process. DNA defects affect each part of the body, i.
Megaloblastic anemia is described as presence of large-sized red blood cells than normal.
It results from the inhibition of DNA synthesis within red blood cell production. Since DNA synthesis becomes impaired, the cell cycle cannot progress and cell continues to grow without division, which presents as macrocytosis. It can be a result of vitamin B12 deficiency and also due to trapping folate, preventing it from doing its normal function.
This defect is caused by thymidylate synthesis defective with deoxyuridine triphosphate enlargement. Megaloblastic anemia leads to impairment of RBC, painful tingling of the hands and feet, gastrointestinal problems e.
Also, formyltetrahydrofolate synthetase, which is known as domain of C1 tetrahydrofolate synthetase gene, has been shown that it is linked to a high risk of having neural tube defect. The most well-known type of this defect is "spina bifida," which can lead to many problems and issues, e.
According to the spina bifida association, it can also lead to learning disabilities, gastrointestinal disorders, obesity, depression, urinary and bowel dysfunction, tendonitis, and allergies.How can folate mask a vitamin B12 deficiency?
Vitamin B12 commonly known as cyanocobalamin is the most chemically complex of all the vitamins.