Everyone Healthy Library
Megaloblastic Macrocytic Anemias
Condition / disease reference page from the Everyone Healthy database.
! Seek urgent medical care if warning signs appear
Some health conditions or symptoms can become urgent. Use this page for education, but seek help quickly if warning signs are present.
Get urgent medical care now if there is any severe, sudden, rapidly worsening or worrying symptom, especially:
- chest pain, pressure or pain spreading to the arm, jaw or back
- trouble breathing, blue lips, severe wheeze or choking
- stroke-like symptoms such as face drooping, arm weakness or speech trouble
- collapse, fainting, seizure, confusion or extreme drowsiness
- severe bleeding, black stools, vomiting blood or major injury
- severe allergic reaction, swelling of the face/throat or widespread rash with breathing trouble
- severe abdominal pain, severe headache, stiff neck or sudden vision change
- signs of severe dehydration, sepsis, high fever with worsening illness, or symptoms in a baby/young child that concern you
Connected health information
Explore this condition in a clear order
Linked signs and symptoms
5Each sign/symptom opens its own page and links back to related conditions.
Linked drugs / medications
0No linked drugs are listed yet.
Treatments, therapies and supportive options
7Grouped by treatment type. These are educational database links, not personal treatment recommendations. Evidence labels are shown only where stored in the EH database.
Medical therapy
1Alternative and complementary therapies
1Vitamins and minerals
3Vitamins
1Linked diagnostic tests and investigations
34These are pulled from both EH diagnostic-test link tables, including the older large test-link table.
- 2,3 Diphosphoglycerate (2,3-DPG) Concentration
- Bleeding Time (Ivy Method)
- Blood Film (Peripheral Blood Smear)
- Blood Uric Acid Concentration Test
- Bone Marrow Test
- Chloride Concentration (Blood)
- Cholesterol Concentration
- Cholinesterase (Serum Acetylcholinesterase, Pseudocholinesterase)
- complete Blood Count (CBC)
- erythrocyte Sedimentation Rate (ESR)
- Erythropoietin (Ep) Concentration
- Ferritin Concentration
- Fibrinogen Concentration test
- Folic Acid (Folate) Concentration
- Free Erythrocyte Protoporphyrin (FEP) Concentration
- Glucose 6 Phosphate Dehydrogenase (G6PD) Concentration
- Heamatocrit (Hct)
- Hemoglobin (Hb) A2 Concentration
- Hemoglobin (Hb) Concentration
- Lactate Dehydrogenase Concentration
- Mean Corpuscular Hemoglobin (MCH) Weight Test
- Mean Corpuscular Hemoglobin Concentration (MCHC)
- Mean Platelet Volume (MPV)
- Oxygen Saturation Test (Arterial Blood, SaO2)
- Partial Pressure of Arterial Carbon Dioxide (PCO2, PaCO2)
- Partial Pressure of Oxygen (PO2)
- Red Blood Cell (RBC) Count
- Red Blood Cell Folate Levels
- Reticulocyte Count
- Serum B12 Levels
- Serum Chemistry
- Shilling Test
- Vitamin B12 (VB12) Concentration
- Vitamin B12 (VB12) Concentration
Biological markers/agents
23This visual map shows biological markers/agents reported as increased or decreased with this condition. These are educational relationships only; test results must be interpreted by a qualified clinician because ranges vary by lab, method, age, sex and clinical context.
Often increased
14- 2,3 Diphosphoglycerate (2,3-DPG)Reference range exampleAdult ( > 16y): 10.5–14 µmol/gLinked diagnostic tests2, 3 Diphosphoglycerate (2
- Chloride (Blood, Cl)Reference range exampleAdult ( > 16y): 97–106 mEq/L; Birth - 2wks: 94–106 mEq/LLinked diagnostic testsChloride Concentration (Blood)
- Cholesterol (Total)Reference range exampleInfant (0 - 1y): 75–180 mg/dL; Adult ( > 16y): 0–190 mg/dLLinked diagnostic testsCholesterol Concentration
- Erythrocyte Sedimentation RateReference range exampleAdult ( > 16y), Female: 0–20 mm/Hr; Adult ( > 16y), Male: 0–15 mm/HrLinked diagnostic testserythrocyte Sedimentation Rate (ESR)
- Erythropoietin (Ep)Reference range exampleAdult ( > 16y): 6–36 units/LLinked diagnostic testsErythropoietin (Ep) Concentration
- FerritinReference range exampleChild (0 - 16y): 7–140 µg/L; Adult ( > 16y), Female: 18–160 µg/LLinked diagnostic testsFerritin Concentration
- Glucose 6 Phosphate Dehydrogenase (G6PD)Reference range exampleAdult ( > 16y): 10.1–18.5 U/gHb; Birth - 2wks: 12–23 U/gHbLinked diagnostic testsGlucose 6 Phosphate Dehydrogenase (G6PD) Concentration
- Hemoglobin (Hb)Reference range exampleFemale: 78–100 gm/dL; Male: 76–100 gm/dLLinked diagnostic testsHemoglobin (Hb) Concentration, Mean Corpuscular Hemoglobin (MCH) Weight Test
- Hemoglobin (Hb) A2Reference range exampleAdult ( > 16y): 1.5–3.5 %; Birth - 2wks: 0–1.8 %Linked diagnostic testsHemoglobin (Hb) A2 Concentration
- Lactate Dehydrogenase (LDH)Reference range exampleInfant (0 - 1y): 120–250 units/L; Adult ( > 16y): 100–200 units/LLinked diagnostic testsLactate Dehydrogenase Concentration
- Mean Platelet VolumeReference range exampleAdult ( > 16y): 7.4–10.4 µm3Linked diagnostic testsMean Platelet Volume (MPV)
- Template Bleeding TimeReference range exampleAdult ( > 16y): 2.5–9 MinutesLinked diagnostic testsBleeding Time (Ivy Method)
- Uric Acid, BloodReference range exampleAdult ( > 16y), Female: 2.5–7 mg/dL; Adult ( > 16y), Male: 4–8 mg/dLLinked diagnostic testsBlood Uric Acid Concentration Test
- Vitamin B12 (VB12)Reference range exampleAdult ( > 16y): 130–670 pmol/LLinked diagnostic testsVitamin B12 (VB12) Concentration
Often decreased
9- CholinesteraseReference range exampleAll: 6–19 U/mLLinked diagnostic testsCholinesterase (Serum Acetylcholinesterase, Pseudocholinesterase)
- FibrinogenReference range exampleAdult ( > 16y): 150–400 mg/dLLinked diagnostic testsFibrinogen Concentration test
- Folic Acid (Folate)Reference range exampleInfant (0 - 1y): 14–51 ng/mL; Child (0 - 16y): 5–21 ng/mLLinked diagnostic testsFolic Acid (Folate) Concentration
- Free Erythrocyte Protoporphyrin (FEP)Reference range exampleAll: 16–37 µg/dLLinked diagnostic testsFree Erythrocyte Protoporphyrin (FEP) Concentration
- Oxygen Saturation (Arterial Blood, SaO2)Reference range exampleChild (0 - 16y): 95–100 %; Newborn (0 - 1month): 40–90 %Linked diagnostic testsOxygen Saturation Test (Arterial Blood, SaO2)
- Partial Pressure of Arterial Carbon Dioxide (PaCO2)Reference range exampleAll: 35–45 mm HgLinked diagnostic testsPartial Pressure of Arterial Carbon Dioxide (PCO2, PaCO2)
- Partial Pressure of Arterial Oxygen (PaO2)Reference range exampleChild (0 - 16y): 80–100 mm Hg; Newborn (0 - 1month): 60–70 mm HgLinked diagnostic testsPartial Pressure of Oxygen (PO2)
- RBC MassReference range exampleFemale: 36–48 %; Male: 42–52 %Linked diagnostic testsHeamatocrit (Hct)
- Red Blood Cells (RBC)Reference range exampleAdult ( > 16y), Female: 3.6–5 106/mm3; Adult ( > 16y), Male: 4.2–5.4 106/mm3Linked diagnostic testsRed Blood Cell (RBC) Count
Introduction / full article
Megaloblastic Macrocytic Anemias
Efficacy of Alternative and Other Treatments According to GRADE* Ranking:
Vitamin B Complex [1, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14]:
Please note, this management does NOT treat the condition itself. It may mildly help in preventing some of the symptoms, and even then has insufficient evidence to back up this claim at present. Please note, this acts as a PREVENTATIVE treatment, and not necessarily symptomatic relief. Supplements should only be taken if they contain no more than 100% of the recommended daily value
Recommendation: weakly in favor (Vitamin B may help in preventing anaemia due to its role in the production of red blood cells)
Grade of Evidence: moderate quality of evidence
Chlorella (Green Algae, Chlorella Pyrenoidosa) [1, 2, 3, 4]:
Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.
Recommendation: no recommendation (There is insufficient evidence to support claims that Chlorella helps to treat anemia in any way)
Grade of Evidence: very low quality of evidence
* www.gradeworkinggroup.org
Summary References
Treatments:
1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009
2. Nakano, S et al. “Maternal-fetal distribution and transfer of dioxins in pregnant women in Japan, and attempts to reduce maternal transfer with Chlorella (Chlorella pyrenoidosa) supplements...” Chemosphere 2005 Dec; 61(9): 1244–55.
3. http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=11347287&dopt=Abstract
4. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/chlorella
5. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/vitamin-b-complex
6. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-folate.html
7. Butterworth RF. Thiamin. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, editors. Modern Nutrition in Health and Disease, 10th ed. Baltimore: Lippincott Williams & Wilkins; 2006.
8. http://www.ncbi.nlm.nih.gov/pubmed/18220605
9. http://news.bbc.co.uk/2/hi/health/6935482.stm
10. http://www.ncbi.nlm.nih.gov/pubmed/19061687
11. Gropper, S. S, Smith, J. L., Groff, J. L. (2009). Advanced nutrition and human metabolism. Belmont, CA: Wadsworth, Cengage learning.
12. Otten, J. J., Hellwig, J. P., Meyers, L. D. (2008). Dietary reference intakes: The essential guide to nutrient requirements. Washington, DC: The National Academies Press
13. http://recipes.howstuffworks.com/vitamin-b1.htm
14. Higdon, Jane (2003). "Biotin". An evidence-based approach to vitamins and minerals. Thieme. ISBN 9781588901248.