Vitamin Deficiency Anemia

Vitamin deficiency anemia is a condition that develops when you have low levels of vitamin B12 or B9 (folate). In this type of anemia, your body doesn’t produce enough healthy red blood cells. You’re more likely to develop this condition if you have a disorder that makes it difficult for your body to absorb nutrients.


What is vitamin deficiency anemia?

Vitamin deficiency anemia is a condition in which your body doesn’t produce enough healthy red blood cells. It happens primarily when you have low levels of vitamin B12 or B9 (folate or folic acid).

Instead of producing healthy red blood cells, your body may produce irregularly large red blood cells. These cells can’t carry oxygen throughout your body the way they should. Because the red blood cells are abnormally large, another name for vitamin deficiency anemia is macrocytic or megaloblastic anemia.


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

How do vitamin B12 or folic acid deficiency cause anemia?

Both vitamins are crucial in many processes in your body, including making red blood cells. Without enough B12 or folic acid, your body doesn’t make normal red blood cells and those cells die more quickly than normal cells so they can’t carry oxygen to all of your body tissues. This lack of normal red blood cells is anemia.

Who is more likely to get vitamin deficiency anemia?

You may develop vitamin deficiency anemia if you don’t consume enough foods with vitamins B12 or folate. Or you may have a condition that makes it hard for your body to process these nutrients, such as:


Symptoms and Causes

What are the symptoms of vitamin deficiency anemia?

Vitamin deficiency anemia symptoms may be mild or subtle. You may notice them gradually worsen over several months or years. You may experience:

Vitamin deficiency can also cause depression, and in severe cases, vitamin B12 deficiency may cause confusion, forgetfulness or even personality changes. In older people, this can sometimes be mistaken for dementia.

What causes vitamin deficiency anemia?

Vitamin deficiency anemia occurs when you have low vitamin B12 or folate levels. Causes of vitamin deficiency anemia may include:

  • Certain medications, such as some anti-seizure drugs.
  • Excessive alcohol use.
  • Health conditions that affect nutrient absorption.
  • History of gastric surgery.
  • Intestinal problems such as tapeworms.
  • Diet that doesn’t include adequate meats/fish, dairy products, eggs, or specific vegan options (B12) or dark green veggies, beans, nuts, seeds (folate).

You are also at a higher risk of a folate deficiency if you are:


Diagnosis and Tests

How is vitamin deficiency anemia diagnosed?

Your healthcare provider can use blood tests to diagnose vitamin deficiency anemia. This blood test may evaluate:

  • Folate and vitamin B12 levels.
  • Red blood cell count and appearance.

Your healthcare provider may request additional tests if they suspect pernicious anemia.

Management and Treatment

How is vitamin deficiency anemia treated?

Treatment for vitamin deficiency anemia aims to increase your levels of the vitamin you’re lacking. Your provider will determine the best dosage and type of treatment.

There are a variety of vitamin B12 or folate supplements, including:

  • Dissolvable tablet.
  • Injection.
  • Intravenous (IV) line.
  • Nasal spray.
  • Pill.

You continue treatment until your vitamin levels increase — changing your diet can also often help a lot. If you have an underlying health condition that led to vitamin deficiency anemia, you will need to continue treatment long-term to prevent a deficiency from returning.


How can I reduce my risk of vitamin deficiency anemia?

You can lower your risk of vitamin deficiency anemia by eating foods rich in vitamins B12 and B9. Foods high in B12 include:

  • Chicken, fish, beef and liver.
  • Eggs.
  • Fortified foods, such as bread or cereal.
  • Yogurt, cheese and milk.

Foods high in B9 (folate) include:

  • Enriched grain foods, such as pasta, cereal and rice.
  • Fruits such as oranges, bananas and strawberries.
  • Dark green and leafy vegetables such as broccoli, spinach and asparagus.

Your healthcare provider can guide you on how much vitamin B12 and B9 you need. They can also measure your current vitamin levels to check for deficiencies. If needed, your provider may prescribe a supplement.

Outlook / Prognosis

What is the outlook for vitamin deficiency anemia?

Most people don’t have long-term complications from vitamin deficiency anemia. With treatment, the condition often goes away.

But it’s important to get treatment for vitamin deficiency anemia. Without treatment, vitamin deficiency anemia could lead to:

  • Difficulty getting pregnant.
  • Heart problems, including heart failure.
  • Nerve problems.
  • Pregnancy complications.

Living With

What questions should I ask my doctor?

If you have suspected vitamin deficiency anemia, you may want to ask your healthcare provider:

  • What is the most likely cause of my symptoms?
  • What tests do I need to diagnose vitamin deficiency anemia?

And if your healthcare provider has already diagnosed you with vitamin deficiency anemia, you may ask:

  • What are the treatment options for vitamin deficiency anemia?
  • What diet changes can I make?
  • How can I prevent vitamin deficiency anemia from returning?

Additional Common Questions

What vitamin deficiency causes hemolytic anemia?

Vitamin E deficiency can lead to anemia hemolytic anemia in infants, particularly if they are born premature. This is a severe type of anemia in which red blood cells break down faster than your body can produce them. Vitamin E deficiency is uncommon in adults.

Does vitamin D deficiency cause anemia?

Vitamin D deficiency may occur in combination with anemia, but it usually doesn’t directly cause it.

A note from Cleveland Clinic

Vitamin deficiency anemia is when your body doesn’t make enough healthy red blood cells. It commonly develops because of a deficiency in vitamins B12 or B9. You have a higher risk of developing vitamin deficiency anemia if you have a diet that could be better, or if you have a condition that makes it difficult for your body to absorb certain nutrients. Treatment for this type of anemia focuses on restoring your B12 or B9 levels. You may take supplements by mouth, injection or through an IV.

Medically Reviewed

Last reviewed on 07/22/2022.

Learn more about our editorial process.

Questions 216.444.2538