Megaloblastic anemia is characterized by red blood cells that are larger than normal and there are not enough of them. This anemia is also known as folate deficiency anemia.
Megaloblastic anemia occurs when red blood cells are not produced properly. Because these immature cells are so large, they may not be able to leave the bone marrow to enter the bloodstream and deliver oxygen.
Two common causes of megaloblastic anemia are vitamin B12 or folate (B9) deficiency. These two nutrients are essential for the production of healthy red blood cells, and when you do not get enough of them, they affect the arrangement of your red blood cells. This leads to the production of red blood cells that do not divide and are larger than usual.

Vitamin B12 deficiency

Some people may not be able to absorb enough vitamin B12 from their diet, which can lead to megaloblastic anemia. Megaloblastic anemia caused by vitamin B12 deficiency is also called pernicious anemia. Vitamin B12 deficiency is often caused by a lack of protein in the stomach called an "internal factor." Vitamin B12 is not absorbed, regardless of how much you consume, when you do not produce an internal factor.

People at risk for vitamin B12 deficiency:

• The elderly

• Those who have had surgery to remove part of their bowel.

•  People taking metformin for diabetes

•  People on a strict vegetarian diet.

• People taking antacids for heartburn.

Folate deficiency

Folate is another nutrient that is important for the growth of healthy red blood cells. Diet is an important factor in ensuring that you have enough folate. Folate deficiency can also be caused by chronic alcohol abuse; Because alcohol interferes with the body's ability to absorb folic acid. Pregnant women are more likely to have folate deficiency due to the high levels of folate needed by the developing fetus.

Symptoms of megaloblastic anemia

• Shortness of breath

•  Muscle weakness

• Abnormal skin discoloration

•  glossitis (swelling of the tongue)

• Decreased appetite or weight loss

•  Diarrhea

• nausea

•  Fast heart rate

• Flat tongue

•  Tingling of the hands and feet

•  Numbness in the limbs

Nutrition and treatment regimen in megaloblastic anemia

In case of vitamin B12 deficiency, monthly injections of vitamins, as well as oral supplements, may be prescribed. Also, foods rich in vitamin B12 include:

• Eggs

•  Liver and offal

•  Sardinia

•  Beef

•  Enriched cereals

• Tuna

• Trout

• Salmon

• Fortified non-dairy milk

• Milk and dairy

Folate deficiency megaloblastic anemia may be treated with oral folic acid supplements or intravenous injections. Dietary changes also help boost folate levels:

• Green leafy vegetables such as broccoli and spinach

•  Citrus

• asparagus

• Beets

• Nuts and seeds

• Cow liver

• Wheat germ

• Banana

• Avocado

• Enriched cereals