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Macrocytic Anaemia : Symptoms, Causes, Diagnosis and Treatment

What is Macrocytic Anaemia?

Macrocytic anemia is a type of anemia that causes unusually large red blood cells. Like other types of anemia, macrocytic anemia means that the red blood cells also have low hemoglobin.

Hemoglobin is an iron-containing protein that transports oxygen around the body. Deficiencies in vitamin B-12 or folate often cause macrocytic anemia, so it is sometimes called vitamin deficiency anemia.

Macrocytic anemia occurs if the red blood cells are unusually large. A unit called femtoliters (fL) is used to measure the size of blood cells. Usually, red blood cells are between 80?100 fL.

Red blood cells larger than 100 fL are considered macrocytic. When the cells grow too large, there are fewer of them than there needs to be and they carry less hemoglobin. This means the blood is not as oxygen-rich as it should be. Low blood oxygen can cause a range of symptoms and health problems.

Macrocytic anemia is not a single disease, but a symptom of several medical conditions and nutritional problems.

One of the most common types of macrocytic anemia is megaloblastic macrocytic anemia. This happens when red blood cells produce DNA too slowly to divide.


Macrocytic anemia can be broken into two main types: megaloblastic and nonmegaloblastic macrocytic anemias.

Megaloblastic macrocytic anemia

Most macrocytic anemias are also megaloblastic. Megaloblastic anemia is a result of errors in your red blood cell DNA production. This causes your body to make red blood cells incorrectly.

Possible causes include:

Nonmegaloblastic macrocytic anemia

Nonmegaloblastic forms of macrocytic anemia may be caused by a variety of factors. These can include:

Macrocytic Anaemia belongs under the category of Blood disease. Megaloblastic macrocytic anemia and Nonmegaloblastic macrocytic anemia are some common types of Macrocytic Anaemia. Generally Male, Female, Child are the victim of the Macrocytic Anaemia. Seriousness of this disease is Medium.

Symptoms of Macrocytic Anaemia are :

  • memory loss
  • Infertility
  • brittle hair and nails
  • Pale skin
  • Shortness of breath
  • Delirium and confusion
  • A faster heartbeat
  • A rapid or fast heartbeat is when your heart is beating faster than normal. A normal heart rate is 60 to 100 beats per minute. Tachycardia is considered a heart rate of greater than 100 beats per minute.
    If you are exercising, or performing any kind of activity, your heart will normally beat faster. This allows your heart to pump blood throughout your body, to provide oxygen to the tissues.
    If you are experiencing fear, anxiety or stress, your heart rate will increase.

    People who can feel their heartbeat, or flutter, may be experiencing palpitations. This may be due to stress, anxiety, medications, or it may be a sign of a serious heart condition. If you experience palpitations, you should report this to your healthcare provider.

  • diarrhea
  • Diarrhea is characterized by loose, watery stools or a frequent need to have a bowel movement. It usually lasts a few days and often disappears without any treatment. Diarrhea can be acute or chronic.

    Acute diarrhea occurs when the condition lasts for one to two days. You might experience diarrhea as a result of a viral or bacterial infection. Other times, it could be due to food poisoning.

    There?s even a condition known as traveler?s diarrhea, which happens when you have diarrhea after being exposed to bacteria or parasites while on vacation in a developing nation. Acute diarrhea is fairly common.

    Chronic diarrhea refers to diarrhea that lasts for at least four weeks. It?s usually the result of an intestinal disease or disorder, such as celiac disease or Crohn?s disease.

  • Weight loss
  • Sudden, noticeable weight loss can happen after a stressful event, although it can also be a sign of a serious illness.

    It's normal to lose a noticeable amount of weight after the stress of changing jobs, divorce, redundancy or bereavement.

    Weight often returns to normal when you start to feel happier, after you've had time to grieve or get used to the change. Counselling and support may be needed to help you get to this stage.

    Significant weight loss can also be the result of an eating disorder, such as anorexia or bulimia. If you think you have an eating disorder, talk to someone you trust and consider speaking to your GP. There are also several organisations that can provide you with information and advice, such as the eating disorders charity Beat.

    If your weight loss wasn't due to one of the causes mentioned, and you didn't lose weight through dieting or exercising, see your GP, as you may have an illness that needs treating.

  • Loss of appetite
  • Fatigue is a constant state of tiredness, even when you?ve gotten your usual amount of sleep. This symptom develops over time and causes a drop in your physical, emotional, and psychological energy levels. You?re also more likely to feel unmotivated to participate in or do activities you normally enjoy.

    Some other signs of fatigue include feeling:

    • physically weaker than usual
    • tired, despite rest
    • as though you have less stamina or endurance than normal
    • mentally tired and moody

    Loss of appetite means you don?t have the same desire to eat as you used to. Signs of decreased appetite include not wanting to eat, unintentional weight loss, and not feeling hungry. The idea of eating food may make you feel nauseous, as if you might vomit after eating. Long-term loss of appetite is also known as anorexia, which can have a medical or psychological cause.

    It may be a warning sign from your body when you feel fatigue and loss of appetite together. Read on to see what conditions may cause these symptoms.

  • Fatigue/weakness
  • Weakness

    Weakness is when strength is decreased and extra effort is needed to move a certain part of the body or the entire body. Weakness is due to loss of muscle strength. Weakness can be a big part of why cancer patients feel fatigue.


    Fatigue is an extreme feeling of tiredness or lack of energy, often described as being exhausted. Fatigue is something that lasts even when a person seems to be getting enough sleep. It can have many causes, including working too much, having disturbed sleep, stress and worry, not having enough physical activity, and going through an illness and its treatment.


    Macrocytic Anaemia can be caused due to:

    Macrocytic anemia is almost always due to a deficiency of folate or vitamin B-12. A person may have a deficiency of one of these if their body cannot absorb vitamins due to an underlying disease, or because they do not eat enough foods with these vitamins.

    B-12 is abundant in animal products, so vegans and vegetarians are more at risk of a B-12 deficiency. In some cases, people may eat enough foods with B-12 but are unable to absorb the vitamin due to autoimmune disorders, cancer, alcohol addiction, or inflammatory bowel disease.

    A folate deficiency, sometimes known as vitamin B-9 deficiency, can also cause macrocytic anemia. Pregnant and breast-feeding women use more folate and have a higher risk of becoming deficient.

    People who do not eat enough folate-rich foods can also become deficient. Diseases that interfere with the body?s ability to absorb nutrition, such as celiac disease, can lead to a folate deficiency.

    Other causes of macrocytic anemia may include:

    • medications, including HIV drugs, cancer drugs, and others that suppress the immune system
    • liver disease
    • hypothyroidism
    • rare metabolic disorders

    Each of these factors can make it more difficult for the body to absorb and metabolize essential nutrients.

    In very rare cases, macrocytic anemia can be caused by a bone marrow disorder that prevents the body from producing enough healthy blood cells.

    What kind of precaution should be taken in Macrocytic Anaemia?

    • Add more red meat and chicken to your diet to increase your vitamin B-12 intake.
    • If you?re a vegetarian or vegan, you can add beans and dark, leafy greens for folate. Try fortified breakfast cereals for vitamin B-12.
    • Reduce the amount of alcohol you drink.
    • Talk to your doctor if you take antiretrovirals for HIV, antiseizure medications, or chemotherapy drugs. These may increase your risk of developing macrocytic anemia.

    Treatment for the Macrocytic Anaemia