In the treatment of megaloblastic anemia, vitamin B12 and folic acid should be given together because
Ans. is 'b' i.e., Folic acid alone causes improvement of anemic symptoms but neurological dysfunction continues Percentage absorption of iron falls progressively as iron deficiency is corrected." As the hemoglobin levels rise, erythropoietin stimulation decreases and the amount of iron reabsorbed is reduced" Oral therapy for iron deficiency anemia A dose of 300 mg of elemental iron given per day in divided doses. 300 mg of elemental rion gives about 50 mg of absorbed iron per day (and not 100 mg of absorbed iron). Typically the Hb levels should be fully corrected within I month of initiating therapy in the absence of continuing blood loss (and not after six months). Treatment should not be stopped after normalizing of Hb, but continued for an additional 4 to 6 months to replenish body iron stores.
Vitamin B12 acts as a cofactor for digydrofolate reductase
Folic acid alone causes improvement of anemic symptoms but neurological dysfunction continues
Vitamin B12 deficiency may result in methylfolate trap
Folic acid is required for conversion of methymalonyl-CoA to succinyl Co-A