To study the masking effect of folic acid on Vitamin B12 deficiency anemia

Sunil Kumar Raina; Jagjit Singh Chahal; K K Sharma; Navjot Kaur

Sunil Kumar Raina Departments of Community Medicine, Himachal Pradesh, India.
Jagjit Singh Chahal Departments of Biochemistry, Dr. RPGMC, Tanda, Kangra, Himachal Pradesh, India.
K K Sharma Department of Biochemistry, Dr. RPGMC, Tanda, Kangra, Himachal Pradesh, India.
Navjot Kaur Department of Pathology, Dr. RPGMC, Tanda, Kangra, Himachal Pradesh, India.

Keywords: Deficiency anemia, Folic acid, Masking, Vitamin B12

Abstract

Background and Aim: A deficiency of either Vitamin B₁₂ or folate can lead to megaloblastic anemia. Folate and Vitamin B₁₂ 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 B₁₂ 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 B₁₂ might have masked the manifestations of Vitamin B₁₂ deficiency. Conclusion: The sufficiency of folic acid in the study group might have masked the overt manifestations of Vitamin B₁₂ deficiency.