What is lacking in megaloblastic anemia?
Dec 12, 2025
Source: Cainiu Health
Dr. Zhang Lu
Introduction
Folic acid is a key component in DNA synthesis during red blood cell production. Deficiency impairs the division and maturation of red blood cells, leading to the formation of abnormally large but dysfunctional megaloblasts. Folate-deficiency megaloblastic anemia may result from insufficient intake of fresh vegetables in the daily diet, improper cooking methods (such as excessive boiling that destroys folic acid), or malabsorption due to intestinal disorders.
In general, megaloblastic anemia is primarily caused by a deficiency in vitamin B12 or folic acid, and there are differences in the mechanisms and manifestations triggered by deficiencies in these two nutrients. If you have concerns, it is recommended to seek medical advice promptly. The detailed analysis is as follows:
Folic acid is a key ingredient required for DNA synthesis during red blood cell production. A deficiency leads to impaired maturation and division of red blood cells, resulting in abnormally large but dysfunctional megaloblasts. Insufficient intake of fresh vegetables in daily diet, improper cooking methods (such as excessive boiling that destroys folic acid), or malabsorption (e.g., due to intestinal disorders) can all lead to folic acid-deficiency megaloblastic anemia.
Vitamin B12 must bind with intrinsic factor secreted by the gastric mucosa to be absorbed in the intestine. A deficiency also disrupts DNA synthesis, leading to the formation of megaloblasts. Common causes include long-term vegetarianism (as plant-based foods contain no vitamin B12), insufficient intrinsic factor secretion after gastrectomy, or reduced intestinal absorption capacity. This type of deficiency may additionally present neurological symptoms such as numbness in hands and feet.
When symptoms such as fatigue, pallor, and decreased appetite occur, timely medical evaluation of vitamin B12 and folic acid levels is necessary. Once the specific deficiency is identified, targeted supplementation should be initiated, along with dietary adjustments to avoid monotonous eating habits or inappropriate cooking practices.
