Introduction
Anemia is a clinical condition of the blood, characterized by a decrease in the number of red blood cells (RBCs) in the body. The function of RBCs is to transport oxygen in the body. Thus, when there are fewer RBCs, the tissues of the body get less oxygen and their normal function is disrupted. There are various types of anemia with different causes and specifications. Megaloblastic anemia is a clinical condition characterized by RBCs that are bigger in size than normal and they are less in number.
How Is It Caused?
There are two main deficiencies that can lead to megaloblastic anemia. They are deficiencies in vitamin B12 and folate. These two micronutrients play a major role in the formation of healthy RBCs. Deficiency of these can lead to disorders related to the division and reproduction of the RBCs.
Vitamin B12 Deficiency:
Vitamin B12 is a micronutrient that is found in foods and drinks like eggs, milk, lamb liver, beef, and other types of meat, sardines, tuna, and other types of fish, fortified nutritional yeast.
Those who cannot absorb enough vitamin B12 from their diet develop megaloblastic anemia. Some people can’t absorb enough vitamin B12 from their diet, leading to megaloblastic anemia.
Another rare type of anemia is pernicious anemia. It is an autoimmune condition and is caused due to the deficiency of a protein in the stomach called intrinsic factor. Also, people following a vegetarian diet may develop this deficiency. Individuals who are taking medications like proton pump inhibitors and metformin may also face vitamin B12 deficiency.
Folate Deficiency:
Folate is yet another micronutrient that is important for the development of healthy RBCs. It is found in various foods like beef liver, spinach, avocados, brussels sprouts, and oranges. Alcohol misuse and inadequate intake of diet may cause these. Pregnant people may also face this as the fetus requires increased amounts of folate.
There are various other names for megaloblastic anemia depending on the cause which is as follows:
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Macrocytic Anemia: In this, the RBCs are bigger in size than normal.
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Folic acid deficiency anemia or folate deficiency anemia.
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Pernicious anemia.
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Vitamin B12 deficiency anemia.
What Are the Symptoms of Megaloblastic Anemia?
Fatigue is the most commonly observed symptom by patients suffering from megaloblastic anemia. The symptoms can be varied from person to person.
Apart from fatigue, the following symptoms may be observed:
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Shortness of breath.
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Weakness in the muscles.
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Pale skin.
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Glossitis – inflammation of the tongue or swelling in the tongue.
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Increased heart rate.
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Smoothness or tenderness in the tongue.
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Loss of appetite.
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Weight loss.
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Nausea.
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Tingling in the hands and feet.
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Numbness in the hands and feet.
How Can It Be Diagnosed?
Your physician will initially inquire about your symptoms and other medical issues. Also, your family history and the medications you are taking will be noted as all these factors help in diagnosing the condition and its cause. Following that, a physical examination will be carried out to check for signs and symptoms of anemia.
Your physician will ask you to undergo some tests to confirm the diagnosis and decide the treatment plan. One of those tests includes a complete blood count (CBC). These tests will help in assessing the number and appearance of the RBCs. The RBCs will appear to be bigger and underdeveloped in patients with megaloblastic anemia. Also, vitamin tests will be conducted to check for deficiency of vitamins.
The Schilling test is a test conducted to check for vitamin B12 absorption capacity. In this test, you are given a small supplement of radioactive vitamin B12. Followed by that, your urine sample is collected. After that you will be asked to take the same radioactive supplement along with the intrinsic factor protein which the body requires to be able to absorb vitamin B12. Then, again another urine sample is taken for comparison with the first sample.
If the result of the urine samples depicts that the patient has absorbed B12 after consumption of intrinsic factor, it is indicative that the patient’s body is unable to produce intrinsic factor on its own.
How Can It Be Treated?
The management of megaloblastic anemia is dependent on causative factors. The treatment plan is also dependent on the age and the general health of the patient. The management of anemia is usually an ongoing type of treatment.
Treatment for Vitamin B12 Deficiency
In the case of megaloblastic anemia caused due to deficiency of vitamin B12, the patient may require monthly injections of vitamin B12. Also, the patient may be given oral supplements. The patient is also advised to include more vitamin B12 containing foods in their diet.
Some of them may be the following:
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Fortified cereals, mainly bran.
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Chicken.
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Red meat.
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Shellfish.
Some patients may have a genetic mutation on a gene called the methylenetetrahydrofolate reductase (MTHFR) gene. This gene helps in the conversion of certain B vitamins like B12 and folate into their usable forms within the body. In such patients, supplemental methylcobalamin is recommended. Regular intake of food containing vitamin B12 and supplements does not guarantee the permanent cure of anemia.
Treatment for Folate Deficiency
Megaloblastic anemia caused due to deficiency of folate may be managed with oral or intravenous supplements of folic acid. Dietary changes also help in boosting folate levels. Following foods can be incorporated into the diet to obtain folate:
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Enriched grains.
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Peanuts.
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Lentils.
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Leafy green vegetables.
Individuals having the MTHFR mutation are advised to consume methyl folate also to prevent deficiency of folate and its associated complications.
Conclusion
Megaloblastic anemia is a blood disorder where the quality and quantity of red blood cells are affected. It can mainly lead to fatigue and if not managed on time, it can lead to serious complications. With the presence of online medical platforms, it has become easy to contact a physician anytime anywhere. You can know more about this condition by contacting a specialist online through online medical platforms.
