Diagnosis of anemia includes tests that measure the level and appearance of red blood cells as seen under the microscope. In anemia, you have fewer red blood cells. In vitamin deficiency anemia, the red blood cells that you do have are large and underdeveloped. In advanced deficiencies, white blood cells and platelets also look abnormal under a microscope.

Blood tests also include a check of the amount of folate, vitamin B 12 and vitamin C in your blood. Folate and vitamin B-12 levels are measured at the same time because these deficiencies often coexist.

When blood tests reveal a vitamin deficiency, your doctor may perform other tests to determine the type and cause. Diagnosing vitamin B-12 deficiency in particular may involve more tests, such as antibodies test. Your doctor may draw a sample of your blood to check for antibodies to intrinsic factor. In the majority of cases, vitamin B 12 deficiency is due to a lack of intrinsic factor, which is a protein secreted by the stomach necessary for the absorption of vitamin B 12. The presence of antibodies to intrinsic factor indicates pernicious anemia, methylmalonic acid test. You may undergo a blood and urine test to measure the presence of a substance called methylmalonic acid. The level of this substance is higher in people with vitamin B 12 deficiency, Schilling test. In this test, you first ingest a tiny amount of radioactive vitamin B 12. Then your blood is checked to see if your body absorbed the vitamin B 12. After that, you ingest a combination of radioactive vitamin B 12 and intrinsic factor. If the radioactive B 12 is absorbed only when taken with intrinsic factor, it confirms you lack your own intrinsic factor. If your body doesn’t absorb vitamin B 12 with or without intrinsic factor, you likely have a more general absorption problem.

To diagnose vitamin deficiency anemias, your doctor may also take a sample of your bone marrow. Using a needle, your doctor removes a sample of bone marrow from your hipbone. The sample is examined under a microscope to rule out other blood disorders with similar signs and symptoms.

Being deficient in vitamins increases your risk of many health problems like birth defects. Lack of folate in pregnant women can lead to birth defects of the brain and spinal cord. During pregnancy, the fetus needs supplemental folic acid to make healthy blood and nerve cells, nervous system disorders. While vitamin B 12 is important for the production of red blood cells, it’s also important for a healthy nervous system. Untreated, vitamin B 12 deficiency can lead to neurological problems, such as persistent tingling in your hands and feet, known as peripheral neuropathy. It can lead to mental confusion and forgetfulness, because vitamin B 12 is also necessary for healthy brain function. Vitamin B-12 deficiency can cause these and other health problems before it leads to anemia and scurvy. Vitamin C deficiency can lead to scurvy. Signs and symptoms of this rare disease include bleeding under the skin and around the gums.

Treatment for vitamin deficiency anemia is with supplements and changes in diet like in folate deficiency anemia. Treatment involves eating a healthy diet and taking folic acid supplements as prescribed by your doctor. In most cases, folic acid supplements are taken orally. It usually takes a month or longer to correct folate deficiency anemia. If you’re someone who cannot absorb folate easily, you may need to take folic acid supplements for life. In vitamin B 12 deficiency anemia or pernicious anemia, you can treat vitamin B 12 deficiency related to a poor diet with changes in your diet along with vitamin B 12 supplementation, under doctors supervision. If your body cannot absorb vitamin B 12, you will either need lifelong vitamin B 12 injections or nasal B 12 spray. At first you will need vitamin B-12 shots or nasal spray daily. Eventually, you need injections or the nasal spray just once a month. Prompt treatment is important because neurological complications may become permanent if the B12 deficiency isn’t corrected within several months. In vitamin C deficiency anemia, treatment for this rare anemia is with vitamin C tablets. Take them as directed by your doctor. Additionally, increase your intake of foods and beverages that contain vitamin C.