Vitamin B12 / folate deficiency

Question 1

what is the treatment for vitamin B12 deficiency?

Answer 1

1g IM hydroxycobalamine 3x per week for 2 weeks then once every 3 months

Question 2

what part of the spinal cord does vitamin B12 deficiency affect first and what symptoms does this cause ?

Answer 2

dorsal column
causes loss of vibration and joint position sense

then as it progresses will cause paraesthesia

Question 3

what are risk factors for folate deficiency?

Answer 3

intestinal absorption abnormalities (duodenum and jejunum)

drugs: trimethoprim, methotrexate, sulfasalazine, anticonvulsants

pregnancy/lactation

low folate in diet

age > 65yrs

alcoholism

prolonged diarrhoea

prematurity

Question 4

how does folate deficiency present?

Answer 4

fatigue
diarrhoea
reduced sense of tast

Question 5

how is folate deficiency treated?

Answer 5

oral folate + cyanocobalamin

important to treat vitamin B12 deficiency because if there is a deficiency underlying then treating folate can mask vitamin B12 deficiency signs and thus cause subacute combined degeneration of the cord