To study the masking effect of folic acid on Vitamin B12deficiency anemia

Abstract

Background and Aim: A deficiency of either Vitamin B 12 or folate can lead to megaloblastic anemia. Folate and Vitamin B 12 metabolism is linked in transfer of a methyl group from N5-methyltetrahydrofolate to cobalamin. Methods: This was an observational study carried out among healthy adults (students and staff) of a medical college in rural Northwest India. Results: Despite the occurrence of suboptimal serum Vitamin B 12 in more than half of our healthy study population on one hand, we observed normal hematological variables such as hemoglobin or lack red blood cell macrocytosis (mean corpuscular volume > 100 fL) among participants as a rule. Folic acid deficiency usually coexists with that of Vitamin B 12 , and this has been reported by many studies in past. Strikingly, our study population had 16.98 ± 5.44 ng/ml as mean serum folic acid which was toward higher side of normal range. This sufficiency of folic acid in the group having suboptimal Vitamin B 12 might have masked the manifestations of Vitamin B 12 deficiency. Conclusion: The sufficiency of folic acid in the study group might have masked the overt manifestations of Vitamin B 12 deficiency.