Vitamin B12 and folic acid (also called “folate”) are 2 different vitamins that your body needs to work normally. A “deficiency” means that your body does not have as much of something as it needs. People can have vitamin B12 deficiency, folic acid deficiency, or both.
Your body needs vitamin B12 for many things. For example, you need vitamin B12 to make new cells, such as red blood cells, and for your nervous system to work normally.
Your body needs folic acid, too, to make new cells. It is especially important that pregnant women get enough folic acid, so that their baby can develop normally in the womb. Unborn babies need folic acid so that parts of their nervous system form correctly.
People can get vitamin B12 or folic acid deficiency when they don’t eat enough foods that have vitamin B12 or folic acid in them or they eat foods with vitamin B12 and folic acid, but their body can’t absorb or use the vitamins normally. These things can happen with certain medical problems or as a side effect of certain medicines.
A deficiency of vitamin B12, folic acid, or both can cause anemia. Anemia is the term medically used when a person has fewer than normal red blood cells. Anemia can cause headaches or make people feel tired or weak all the time.
A vitamin B12 deficiency can also cause other symptoms such as tingling or numbness in the hands or feet, trouble walking, mood changes or memory problems or trouble thinking clearly.
The diagnosis of vitamin B12 or folic acid deficiency is made through taking the patients history of the symptoms, diet history, physical examination and some investigations can be done to confirm the conditions.
Vitamin B12 deficiency is treated by giving vitamin B12. The treatment comes as a shot or as pills. Most people with vitamin B12 deficiency need vitamin B12 shots, especially at first. Later, you might be able to take vitamin B12 pills instead of getting shots.
Folic acid deficiency can be treated by giving folic acid. This treatment comes as a pill.
Your doctor will also treat the cause of your deficiency, if it can be treated. If you need help changing your diet, your doctor or nurse might recommend that you work with a dietitian (food expert) or recommend the best diet with these vitamins.
You can lower your chances of getting vitamin B12 deficiency and folic acid deficiency by eating foods that have the vitamins in them.
Foods with a lot of vitamin B12 include; red meat, fish and shellfish, dairy foods, breakfast cereals that have vitamin B12 added to them.
Foods with a lot of folic acid include; green leafy vegetables, oranges and orange juice, breakfast cereals that have folic acid added to them.
If you don’t eat these foods, your doctor or dietician might recommend that you take a vitamin supplements. Vitamin supplements are pills, capsules, or liquids that have nutrients in them.
If you are a “pure” vegetarian and do not eat any meats, dairy foods, or eggs, you will not get enough vitamin B12 from your diet alone. To avoid getting a vitamin B12 deficiency, you will need to take a vitamin B12 supplement or eat foods with vitamin B12 added to them.
Folic acid is needed for normal development of the brain, spinal cord and vertebrae and hence deficiency of folic in pregnancy increases the risk of giving birth to a baby with incomplete development of the spinal cord or vertebrae, incomplete development of the major parts of the brain. Folic acid deficiency in pregnancy is also associated with certain conditions of the baby such as cleft lip and palate, premature birth, low birth weight, miscarriage or poor growth in the womb.
If you want to get pregnant, it is advisable to take a “prenatal” multivitamin every day that has at least 400 micrograms of folic acid. This helps prevent some birth defects. Start taking the multivitamin at least a month before you start trying to get pregnant. It’s not enough to start taking vitamins when you find out you are pregnant. At that point, your baby has already formed many body parts that rely on folic acid and other vitamins to develop normally.
It is, however, important not to take too much of any vitamin during pregnancy, especially vitamin A, hence medical advice needs to be sought before taking these vitamins in pregnancy.
Dr Ian Shyaka is a General Practitioner at Rwanda Military Hospital