Iron, B12 and folate

Iron, B12 and folate are required for essential metabolic functions in the body. The deficiency states of these nutrients are clinically important because they are common conditions and, untreated, can cause severe morbidity and, previously for pernicious anaemia, mortality. Although disordered haematopoiesis is a frequent finding in iron, B12 and folate deficiency, widespread effects in other organ systems may also occur and may precede the appearance of haematological abnormalities. Investigation of suspected iron, B12 or folate deficiency should be directed at establishing that the deficiency state exists, as well as determining its cause, and should always include a detailed history and physical examination as well as relevant laboratory tests. Correcting the deficiency with supplements is usually straightforward, provided adherence to treatment is ensured. The underlying cause of the nutritional deficiency should also be treated where possible. Blood transfusion should be avoided unless symptoms dictate otherwise.