A lack of certain vitamins and minerals, including folic acid and vitamin B-12 can make it hard for your body to produce red blood cells, resulting in anemia. Anemias due to a lack of folate or B-12 can cause certain characteristic changes in the size of your red blood cells, resulting in a condition known as macrocytosis.
Macrocytosis
Macrocytosis is a term used to describe red blood cells that are larger than usual. It is detected via blood tests that measure the amount and size of your red blood cells. Macrocystosis can be caused by various health problems, including liver disease, alcoholism, the use of some chemotherapy drugs and a lack of certain vitamins, including folate and vitamin B-12.
Vitamin B-12
Vitamin B-12 is a member of the B family of vitamins and it has a crucial role in making new DNA and red blood cells. Your body also needs vitamin B-12 to make myelin, a protein that covers and protects your nerves. A lack of vitamin B-12 can be due to inadequate intake or due to problems absorbing this vitamin. Vitamin B-12 deficiencies cause anemia with unusually large red blood cells, also known as a macrocytic anemia. Patients with a B-12 deficiency also may develop tingling or numbness in their extremities due to neuropathy.
Folate
Folate, also known as folic acid, is another nutrient essential for making red blood cells. Folate can be found in liver and green leafy vegetables, and you need to regularly consume folate since little is stored in your body. Much like vitamin B-12, a lack of folate can cause a macrocytic anemia. However, folate does not play any role in the nervous system and a folate deficiency will not cause neuropathy.
Considerations
Macrocytosis is a complex disorder that requires additional testing to determine the cause. This is especially important if a vitamin deficiency is suspected. Blood tests to identify the levels of both folate and vitamin B-12 are needed to identify if you are deficient in one or both of the vitamins. Giving folate for a vitamin B-12 deficiency may correct the macrocytosis, but it can exacerbate the neurological problems, so it is essential to identify the underlying cause of the macrocytosis.
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