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Deficiencies of Vitamin B 12 or folate produce a macrocytic anemia (large cell anemia) in which the RDW is elevated in roughly two-thirds of all cases. However, a varied size distribution of red blood cells is a hallmark of iron deficiency anemia, and as such shows an increased RDW in virtually all cases.
Folate deficiency is diagnosed by analyzing a complete blood count (CBC) and plasma vitamin B 12 and folate levels. A serum folate of 3 μg/L or lower indicates deficiency. [98] Serum folate level reflects folate status, but erythrocyte folate level better reflects tissue stores after intake. An erythrocyte folate level of 140 μg/L or lower ...
It thus is also a biomarker for intracellular levels of folate. The FIGLU test is used to identify vitamin B₁₂ deficiency, folate deficiency, and liver failure or liver disease. [1] [2] It is elevated with folate trapping, where it is accompanied by decreased methylmalonic acid, increased folate and a decrease in homocysteine. [3]
Diagnosis is not always straightforward as serum levels can be falsely high or normal. [10] Elevated methylmalonic acid levels may also indicate a deficiency. [2] Individuals with low or marginal values of vitamin B 12 in the range of 148–221 pmol/L (200–300 pg/mL) may not have classic neurological or hematological signs or symptoms. [2]
In contrast, optimal (health) range or therapeutic target is a reference range or limit that is based on concentrations or levels that are associated with optimal health or minimal risk of related complications and diseases. For most substances presented, the optimal levels are the ones normally found in the population as well.
Hyperhomocysteinemia is a medical condition characterized by an abnormally high level of total homocysteine (that is, including homocystine and homocysteine-cysteine disulfide) in the blood, conventionally described as above 15 μmol/L. [1]
[56] [57] Low levels of serum vitamin B 12 may be caused by other factors than B 12 deficiency, such as folate deficiency, pregnancy, oral contraceptive use, haptocorrin deficiency, and myeloma. [57] High serum levels may caused by supplementing with vitamin B 12, present of antibodies to intrinsic factor, or due to underlying condition. [56]
Folate levels in the individual may affect the course of pathological changes and symptomatology of vitamin B 12 deficiency. Vitamin B 12 deficiency in pregnant women is strongly associated with an increased risk of spontaneous abortion, congenital malformations such as neural tube defects, and problems with brain development growth in the ...