I’m not a medical professional or a scientist, I’m trying to parse blood test results (without much help from my GP). I understand B12 is used to make red blood cells; is that why living with iron deficiency (without anemia) has made my B12 go down by 1/3 in 3 years? Not a vegan or vegetarian, and under 40.
Many thanks to anyone who can explain it!
In: Biology
You could have pernicious anemia. Also, drinking alcohol effects b12 as well as certain over the counter medications. Low iron would not cause your b12 deficiency, but low b12 can cause issues with your red bloodcell production.
You should bring these questions up with your doctor.
B12/folate anaemia, and iron deficient anaemia are actually two separate anaemias, which each cause red blood cells to behave differently.
B12 and folate (another B vitamin), yes, as you say, *are* required for RBC formation, but they tend to cause dysmorphia of the RBCs by making them grow too big. This is why we call it a ‘macrocytic’ (‘big cell’) anaemia. B12 deficiency is most often dietary, but there are some medical conditions which can contribute to it too:
– the inability to absorb B12 (because of lack of ‘intrinsic factor’, a stomach chemical that facilitates the absorption of B12 in the small intestine.) this is called ‘pernicious anaemia’;
– or because of surgery to remove some of the small intestine, or stomach
– chronic gastritis (stomach inflammation)
– thyroid disease
B12 deficiency is treated by identifying the cause and rectifying if possible, and supplementation. B12 or ‘hydroxycobalamin’ injections can be used, or tablets.
By contrast, iron deficiency normally makes the blood cells too small, and is usually a ‘microcytic anaemia’. Iron is required by RBCs to link together the haemoglobin molecules that piggy-back oxygen around the body. Most iron co-habitates with haemoglobin on red blood cells, but also about 30% of it lives in the spleen, bone marrow and liver.
Iron deficient anaemia is most often caused by:
– insufficient iron intake in the diet
but can also be caused by:
– heavy periods, internal bleeding or other blood loss
– iron malabsorption in the gut
– pregnancy (because the volume of blood circulating in the mother increases dramatically, and the iron can’t quite keep up. Sometimes known as ‘dilutional anaemia’.)
If you are iron deficient, iron supplementation is, for the vast majority of people, the best way to top up. This can be done by tablet or infusion. It is extremely hard, some GPs say impossible, to make up for iron deficiency with diet alone – you’d need to eat over 6kg of tofu a day! An iron infusion (iron through a drip) can be done in many clinics, or iron tablets every second day are very helpful. The reason for every *second* day is that when we ingest iron, the liver produces an enzyme called hepcidin when pretty much blocks iron absorption for the next 24 hours – so if you took the iron tablet every single day, every second day would be blocked and redundant!
But important with any deficiency is to work out *why* it’s happening, so that you can treat the root cause and not just put a band-aid on the symptoms alone. Keep in touch with your doctor, and discuss with them what they are ruling out.
It’s like the alphabet soup of vitamins and minerals! Low iron, B12, and D might team up to make you feel like you’re running on empty—think of them as the Avengers of your energy levels.
Are.you on metformin? That inhibits B12 apparently.
You should ask a medical professional. Reddit is not one. Ever. Do not make medical decisions based on something someone said on the internet.
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