Common Causes Of Macrocytic Anemia: Symptoms And Treatment

Macrocytosis is a condition when you have RBCs which are larger than normal. Characteristically, there are no signs and symptoms and is typically detected during routine blood investigations. In severe cases, various symptoms of anemia become apparent.

Macrocytosis is not a definite disease condition, but it does signify the presence of an underlying disorder which needs medical assessment.

Common causes of macrocytic anemia are:

  • Vitamin B 12 deficiency
  • Folate deficiency
  • Alcoholism
  • A liver disorder
  • Hypothyroidism
  • A side effect of certain drugs like the ones used to treat seizures, cancer and autoimmune disorders.
  • Increased RBC synthesis by the bone marrow, especially, after extreme blood loss.

Signs And Symptoms Of Macrocytic Anemia

Common manifestations include:

  • Extreme exhaustion and weakness.
  • Breathlessness and gasping due to inadequate oxygenation of the tissues.
  • Headache is a fairly common symptom.
  • Sore tongue and glossitis (inflammation of the tongue) is seen in vitamin B12 and folic acid deficiency.
  • Diarrhea and GI upsets.
  • Paresthesia or disturbances in the gait.
  • Irritability and poor concentration.

Treatment Options For Macrocytic Anemia

Confer with your health care provider regarding your symptoms; he will examine you and ask you to carry out a battery of tests and investigations to understand the precise cause in your case.

A complete blood count is indicated. The hemoglobin concentration will help establish the diagnosis and confirm the presence and intensity of anemia. White blood cell and platelet counts reduce in primary marrow disturbances. The mean cell volume is calculated. An MCV that is greater than 100 fL is macrocytosis by definition.

An assessment of the size of the RBCs is very essential to the diagnosis of anemia, hence, MCV is considered to be the most vital of the RBC indices. You also need to have your vitamin profile done, to evaluate vitamin B 12 as well as folate levels.

  • Treatment of macrocytic anemia depends up on the underlying cause. When there is vitamin B 12 or folate deficiency, the treatment will include dietary supplements or injections along with dietary changes to step up the vitamin levels appreciably. Discuss with your physician which supplements are best for you. Patients deficient in vitamin B 12 and / or folate may need replacement therapy too. Folate 1 mg/day may be prescribed for folate deficiency. Vitamin B 12 injections intramuscular (100-1000 mcg/mo) will be prescribed. Also, incorporate plenty of green leafy vegetables (spinach, fenugreek, kale), egg yolk, beetroot, tomatoes and milk in to your everyday diet plan. These are loaded with vitamin B 12 as well as folates and will help deal with the symptoms quickly.
  • In case of severe anemia, a blood transfusion may be necessary. Transfusion is usually done with packed red blood cells.
  • If a particular medication is the cause of your condition, more so, if hemolysis is occurring, you need to discontinue the use of the offending drug. Discuss with your doctor about how to stop the medicine and whether a substitute is possible.
  • In case of alcohol abuse, you need to quit drinking altogether.
  • You need to treat liver diseases, cancer, granulomatous diseases, and chronic obstructive pulmonary disease according to the appropriate standards for each.
  • Hospitalization could be needed to treat some causes, in particular acute leukemias.