To help diagnose vitamin deficiency anemias, you might have blood tests that check for:

  • The number and appearance of red blood cells
  • The amount of vitamin B-12 and folate in the blood
  • The presence of antibodies to intrinsic factor, which indicates pernicious anemia


Vitamin deficiency anemia is treated with doses of whichever vitamin is lacking. For pernicious anemia, vitamin B-12 is usually delivered via injection and may need to be taken regularly for the rest of your life.

Vitamin B-12 is available as:

  • Injections into a muscle or under the skin
  • Pills to be swallowed
  • A liquid or tablet that dissolves under the tongue
  • Nose gel or sprays

Medications to boost folate levels usually come as pills to be swallowed, but some versions can be delivered through a narrow, flexible tube into a vein (intravenously).

Preparing for your appointment

If you suspect that you have vitamin deficiency anemia, you're likely to start by seeing your family doctor or a general practitioner. However, in some cases, you may be referred to a doctor who specializes in treating blood disorders (hematologist).

Here's some information to help you get ready for your appointment and what to expect from your doctor.

What you can do

  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications as well as any vitamins or supplements you're taking.
  • Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. For vitamin deficiency anemia, some basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • Could anything else be causing my symptoms?
  • Is my condition likely temporary or long lasting?
  • What treatment do you recommend?
  • Are there any alternatives to the approach that you're suggesting?
  • I have another health condition. How can I best manage these conditions together?
  • Are there any foods I need to add to my diet?
  • Are there any brochures or other material that I can take with me? What websites do you recommend?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment anytime that you don't understand something.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to spend more time on. Your doctor may ask:

  • When did you begin experiencing symptoms?
  • How severe are your symptoms?
  • Does anything seem to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Are you a vegetarian?
  • How many servings of fruits and vegetables do you usually eat in a day?
  • Do you drink alcohol? If so, how often, and how many drinks do you usually have?
  • Are you a smoker?

Feb 07, 2024

  1. Kellerman RD, et al. Pernicious anemia/megaloblastic anemia. In: Conn's Current Therapy 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed Aug. 18, 2021.
  2. Megaloblastic macrocytic anemias. Merck Manual Professional Version. https://www.merckmanuals.com/professional/hematology-and-oncology/anemias-caused-by-deficient-erythropoiesis/megaloblastic-macrocytic-anemias?query=vitamin%20deficiency%20anemia. Accessed Aug. 18, 2021.
  3. Means RT, et al. Clinical manifestations and diagnosis of vitamin B12 and folate deficiency. https://www.uptodate.com/contents/search. Accessed Aug. 18, 2021.
  4. Means RT, et al. Causes and pathophysiology of vitamin B12 and folate deficiency. https://www.uptodate.com/contents/search. Accessed Aug. 18, 2021.
  5. Goldman L, et al., eds. Approach to the anemias. In: Goldman-Cecil Medicine. 26th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Aug. 18, 2021.
  6. AskMayoExpert. Pernicious anemia. Mayo Clinic; 2021.
  7. Kaushansky K, et al., eds. Folate, cobalamin, and megaloblastic anemias. In: Williams Hematology. 10th ed. McGraw Hill; 2021. https://accessmedicine.mhmedical.com. Accessed Aug. 18, 2021.
  8. Pernicious anemia. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/pernicious-anemia. Accessed Aug. 18, 2021.
  9. 2020-2025 Dietary Guidelines for Americans. U.S. Department of Health and Human Services and U.S. Department of Agriculture. https://www.dietaryguidelines.gov. Accessed Oct. 21, 2021.
  10. Means RT, et al. Treatment of vitamin B12 and folate deficiency. https://www.uptodate.com/contents/search. Accessed Aug. 18, 2021.
  11. Vitamin B12: Fact sheet for health professionals. National Institutes of Health Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional. Accessed Oct. 4, 2021.


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