Self-management

Prevention

Choose a healthy diet

You can prevent some forms of vitamin deficiency anemias by choosing a healthy diet that includes a variety of foods.

Foods rich in folate include:

  • Dark green leafy vegetables
  • Nuts
  • Enriched grain products, such as bread, cereal, pasta and rice
  • Fruits and fruit juices

Foods rich in vitamin B-12 include:

  • Eggs
  • Fortified foods, such as breakfast cereals
  • Milk, cheese and yogurt
  • Red and white meats and shellfish

Foods rich in vitamin C include:

  • Broccoli
  • Citrus fruits and juices
  • Strawberries
  • Sweet peppers
  • Tomatoes

Most adults need these daily dietary amounts of the following vitamins:

  • Vitamin B-12 — 2.4 micrograms (mcg)
  • Folate or folic acid — 400 mcg
  • Vitamin C — 75 to 90 milligrams

Pregnant and breast-feeding women may require more of each vitamin.

Consider a multivitamin

If you're concerned about getting enough vitamins from the food you eat, ask your doctor whether a multivitamin may be right for you. Most people get enough vitamins from the foods they eat. But if your diet is restricted, you may wish to take a multivitamin.

Don't smoke

Smoking interferes with the absorption of nutrients, such as vitamin C, so it can raise your risk of a vitamin deficiency. If you smoke, quit. If you don't smoke, don't start. If you've tried to quit on your own and haven't been successful, talk with your doctor about strategies to help you quit.

Drink alcohol in moderation, if at all

Alcohol can contribute to vitamin deficiency anemia. If you choose to drink alcohol, do so in moderation. For healthy adults, moderate drinking is generally considered to be:

  • Two drinks a day for men age 65 and younger
  • One drink a day for men older than age 65
  • One drink a day for women of any age

A drink is 12 ounces (355 milliliters) of beer, 5 ounces (148 milliliters) of wine or 1.5 ounces (44 milliliters) of 80-proof distilled spirits.

Nov. 09, 2016
References
  1. Kaushansky K, et al. Folate, cobalamin, and megaloblastic anemias. In: Williams Hematology. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2016. http://accessmedicine.mhmedical.com/content.aspx?sectionid=101237678&bookid=1581&Resultclick=2#1121092138. Accessed Oct. 10, 2016.
  2. Schrier SL, et al. Etiology and clinical manifestations of vitamin B12 and folate deficiency. http://www.uptodate.com/home. Accessed Oct. 10, 2016.
  3. 2015-2020 Dietary Guidelines for Americans. U.S. Department of Health and Human Services and U.S. Department of Agriculture. https://health.gov/dietaryguidelines/2015/guidelines/.  Accessed Oct. 10, 2016.
  4. Goldman L, et al., eds. Approach to the anemias. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed Sept. 18, 2016.
  5. Pazirandeh S, et al. Overview of water-soluble vitamins. http://www.uptodate.com/home. Accessed Oct. 10, 2016.
  6. Vitamin C: Fact sheet for health professionals. National Institutes of Health Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/.  Accessed Oct. 10, 2016.
  7. Schrier SL. Diagnosis and treatment of vitamin B12 and folate deficiency. http://www.uptodate.com/home. Accessed Oct. 10, 2016.
  8. Walker BR, et al. Environmental and nutritional factors in disease. In: Davidson's Principles and Practice of Medicine. 22nd ed. London, England: Churchill Livingston Elsevier; 2014. http://www.clinicalkey.com.
  9. Folate: Fact sheet for health professionals. National Institutes of Health Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/.  Accessed Oct. 10, 2016.
  10. Alcohol and public health: Frequently asked questions. Centers for Disease Control and Prevention. http://www.cdc.gov/alcohol/faqs.htm. Accessed Oct. 10, 2016.
  11. Mesa RA (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 17, 2016.