Vitamin B12 or folate deficiency anaemia - NHS
of supplemental folic acid per day. More than this can cause symptoms of vitamin B12 deficiency. This may lead to nervous system problems and eventually. See your GP if you think you may have a vitamin B12 or folate deficiency. These conditions can often be diagnosed based on your symptoms and the results of a . We examined the relations between serum folate and vitamin B status relative Keywords: Aging, anemia, cognition disorders, folate, fortified food, nutrition.
Assessment of anemia and macrocytosis Anemia and macrocytosis were assessed on the basis of hemoglobin concentrations and mean cell volumes, which were measured at the mobile examination center laboratory with a MAXM hematology flow cytometer Beckman Coulter Inc, Fullerton, CA. Assessment of cognitive function The cognitive function of seniors was assessed by using a version of the Digit Symbol-Coding subtest of the Wechsler Adult Intelligence Scale III—a screening test designed to detect cognitive impairment in adults and children In the test, participants copy symbols that are paired with numbers.
Using the key provided at the top of the exercise form, the participant draws the symbol under the corresponding number. The score, which declines with age 28is the number of correct symbols drawn within s.
One point is given for each correctly drawn symbol completed within the time limit for a maximum score of According to NHANES documentation, aptitudes needed for a high score are response speed, sustained attention, visual spatial skills, associative learning, and memory However, research suggests that speed is the prime determinant of performance on the test Serum methylmalonic acid MMA was measured by gas chromatography—mass spectrometry with cyclohexanol derivatization Serum homocysteine was analyzed by using a commercially available fluorescence polarization immunoassay kit Abbott Laboratories, Abbott Park, IL on the Abbott IMx analyzer Serum creatinine concentration was based on the Jaffe reaction, and serum glucose was determined by using a hexokinase enzymatic method.
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. 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.
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.
Vitamin B12 And Folic Acid | Dr. Schweikart
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.
Vitamin B12 commonly known as cyanocobalamin is the most chemically complex of all the vitamins. The structure of vitamin B12 is based on a corrin ring, which is similar to the porphyrin ring found in heme, chlorophyll, and cytochrome and has two of the pyrrole rings directly bonded. Cyanocobalamin cannot be made by plants or animals; bacteria and archaea are the only types of organisms that have the enzymes required for the synthesis of cyanocobalamin.
Higher plants do not concentrate cyanocobalamin from the soil, and so are poor sources of the substance, as compared with animal tissues. Vitamin B12 is naturally found in foods including meat especially liver and shellfisheggs, and milk products.
Vitamin B12 And Folic Acid
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