Question 1

What is Macrocytic Anemia?

Accepted Answer

Macrocytic anemia is a condition characterized by abnormally large red blood cells with an elevated mean corpuscular volume (MCV). It is caused by vitamin B12 deficiency, folate deficiency, or certain medications that interfere with DNA synthesis in developing red blood cells. The Complete Blood Count (CBC) is the most important test for diagnosis because it measures MCV and identifies the enlarged red blood cells that define this condition.

Question 2

What causes macrocytic anemia?

Accepted Answer

Macrocytic anemia is caused by vitamin B12 deficiency, folate deficiency, or medications that disrupt DNA synthesis in developing red blood cells. Vitamin B12 deficiency can result from pernicious anemia (an autoimmune condition affecting B12 absorption), dietary insufficiency in vegetarians and vegans, or gastrointestinal disorders like Crohn disease or celiac disease that impair nutrient absorption. Folate deficiency may occur due to poor dietary intake, alcoholism, pregnancy demands, or medications like methotrexate. Certain chemotherapy drugs, antiretroviral medications, and chronic alcohol use can also directly interfere with red blood cell maturation, leading to enlarged cells and anemia.

Question 3

What is the best test for macrocytic anemia?

Accepted Answer

The Complete Blood Count (CBC) is the most important test for macrocytic anemia because it measures the mean corpuscular volume (MCV), which directly identifies enlarged red blood cells. An MCV above 100 femtoliters indicates macrocytosis, the hallmark of this condition. Once macrocytic anemia is confirmed, the Vitamin B12 test is essential to identify vitamin B12 deficiency, one of the most common and treatable causes. These tests together provide a comprehensive picture: the CBC detects the enlarged cells and anemia, while the B12 test pinpoints the underlying nutritional deficiency requiring supplementation therapy.

Question 4

When should I get tested for macrocytic anemia?

Accepted Answer

You should get tested if you experience persistent fatigue, weakness, pale or yellowish skin, shortness of breath, dizziness, or tingling and numbness in your hands and feet. Testing is especially important if you follow a strict vegetarian or vegan diet, have a history of digestive disorders affecting nutrient absorption, take medications like methotrexate or proton pump inhibitors, or are over age 60 when B12 absorption naturally declines. Early detection through blood testing can prevent serious complications like neurological damage from prolonged B12 deficiency.

Question 5

What are the symptoms of macrocytic anemia?

Accepted Answer

Macrocytic anemia symptoms include fatigue, weakness, pale or yellowish skin, shortness of breath with minimal exertion, rapid or irregular heartbeat, and dizziness. When caused by vitamin B12 deficiency, you may also experience neurological symptoms like tingling or numbness in hands and feet, difficulty walking, memory problems, confusion, and mood changes. Some people notice a sore, red tongue (glossitis), mouth ulcers, or changes in taste. Symptoms typically develop gradually over months, making them easy to overlook initially, but they progressively worsen without treatment.

Question 6

Who is at risk for macrocytic anemia?

Accepted Answer

People at higher risk for macrocytic anemia include vegetarians and vegans who do not supplement with vitamin B12, adults over 60 years old with declining stomach acid production, individuals with pernicious anemia or other autoimmune conditions, and those with digestive disorders like Crohn disease, celiac disease, or who have had gastric bypass surgery. Chronic alcohol users, pregnant women with increased folate demands, people taking certain medications (methotrexate, proton pump inhibitors, metformin), and individuals with chronic kidney disease also face elevated risk. Anyone with a family history of pernicious anemia should be especially vigilant about testing.

Question 7

What happens if macrocytic anemia is left untreated?

Accepted Answer

Untreated macrocytic anemia can lead to serious and potentially irreversible complications, especially when caused by vitamin B12 deficiency. Neurological damage can occur, including peripheral neuropathy with permanent nerve damage, difficulty walking and balance problems, cognitive decline, memory loss, and dementia-like symptoms. The heart may become strained from compensating for reduced oxygen delivery, potentially leading to heart enlargement and heart failure. Severe B12 deficiency can cause depression, irritability, and psychosis. Pregnant women with folate deficiency face increased risk of neural tube defects in their babies. Early diagnosis and treatment can prevent these serious outcomes.

Question 8

Can macrocytic anemia be diagnosed with a blood test?

Accepted Answer

Yes, macrocytic anemia is primarily diagnosed through blood tests. The Complete Blood Count (CBC) measures your MCV to detect enlarged red blood cells and assesses hemoglobin levels to confirm anemia. When macrocytosis is identified, follow-up tests like Vitamin B12 and folate levels determine the underlying cause. Additional tests may include a peripheral blood smear to examine red blood cell appearance, methylmalonic acid and homocysteine levels to confirm B12 deficiency, and intrinsic factor antibodies to diagnose pernicious anemia. Blood testing provides definitive diagnosis and guides appropriate treatment.

Question 9

How is macrocytic anemia treated?

Accepted Answer

Treatment for macrocytic anemia depends on the underlying cause. Vitamin B12 deficiency is treated with B12 supplementation, either through oral tablets, sublingual forms, or intramuscular injections for people with absorption problems. Folate deficiency requires folic acid supplementation, typically oral tablets taken daily. If medications are causing the condition, your doctor may adjust dosages or switch to alternatives. Pernicious anemia requires lifelong B12 injections since the body cannot absorb the vitamin naturally. Dietary changes like adding fortified cereals, meat, fish, eggs, and dairy can support treatment. Most people see improvement in symptoms within weeks of starting treatment, though neurological recovery may take longer.

Question 10

How can I prevent macrocytic anemia?

Accepted Answer

You can prevent macrocytic anemia by ensuring adequate intake of vitamin B12 and folate through diet or supplementation. Eat foods rich in B12 like meat, fish, eggs, dairy products, and fortified cereals, or take B12 supplements if you follow a vegetarian or vegan diet. Consume folate-rich foods including leafy green vegetables, legumes, citrus fruits, and fortified grains. Limit alcohol consumption, which interferes with folate absorption and utilization. If you take medications that affect B12 absorption like metformin or proton pump inhibitors, discuss supplementation with your healthcare provider. Regular blood testing can catch deficiencies early, especially if you have risk factors.

Question 11

What can I do at home for macrocytic anemia?

Accepted Answer

At home, focus on dietary improvements and proper supplementation under medical guidance. Add B12-rich foods like salmon, tuna, beef, chicken, eggs, and fortified plant-based milk to your meals. Incorporate folate sources such as spinach, kale, broccoli, lentils, chickpeas, oranges, and fortified breakfast cereals. Take prescribed B12 or folate supplements consistently as directed by your healthcare provider. Reduce alcohol consumption, which depletes folate stores. Get adequate rest to combat fatigue, and pace activities to conserve energy. Keep a symptom journal to track improvements after starting treatment. While dietary changes support recovery, they cannot replace medical treatment for diagnosed deficiencies requiring supplementation.

Question 12

How’s this work?

Accepted Answer

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Question 13

How do I know which test to get?

Accepted Answer

In the test options, find the test you want.
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Question 14

When will my lab results be available?

Accepted Answer

Most test results will be available within 1–3 business days. Once they're ready, we'll send an email and text message to let you know.
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Question 15

Is it possible to make changes to my lab order if I made a mistake with the name, date of birth, or any other details?

Accepted Answer

Absolutely! We totally understand that errors can happen. No worries, we're here to help you.
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Question 16

Do you accept health insurance?

Accepted Answer

Only HSA & FSA is accepted.
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Question 17

Can I cancel my order?

Accepted Answer

Yes.
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Question 18

How can I find a lab location near me?

Accepted Answer

During the ordering process, you’ll be able to select a specific lab near you, with no strings attached!
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Macrocytic Anemia Blood Test

What is Macrocytic Anemia?

What causes macrocytic anemia?

What is the best test for macrocytic anemia?

When should I get tested for macrocytic anemia?

References

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