A lack of certain B vitamins can also cause anemia. Two of the most common culprits are folic acid (b9) and vitamin b12. In this type of anemia the number of red blood cells is diminished and the cells present become larger. The lower numbers and change in red blood cells result in a decreased amount of oxygen to the body. These deficiencies can be seen together or as separate issues.
Folic acid deficiency can cause low energy, pale skin, lack of appetite, irritability, diarrhea and a smooth tongue. A deficiency in b12 can have all of the same symptoms but may also have neurological symptoms. Those can include tingling or numbness in the hands or feet, mental changes and even severe dementia. (http://www.labtestsonline.org/understanding/conditions/vitaminb12.html)
The reason for this type of anemia to be seen in IBD is similar to why we see iron deficiency anemia. Many patients are just not consuming adequate amounts of nutrients while dealing with IBD. This translates into those foods containing b12 and folic acid as well. Inflammation in the GI tract, diarrhea, surgery to remove portions of the GI tract, loss of cells that secrete acid and intrinsic factor (for b12 absorption) and certain medications can all contribute to anemia. (http://www.b12patch.com/about-b12deficiency.html). If you have any of these risk factors it is important to maintain continuing care from a physician to prevent or manage anemia.
Some good food sources of b12 include milk, eggs, fish, meat, poultry and fortified cereals. Leafy greens vegetables, nuts, legumes, whole grains and organ meats are all good sources of folic acid. (http://www.vitamindeals.info/articles/vitamin-b.html). Though it is usually necessary to treat a deficiency with a supplement it is still imperative to support the body with adequate intake as much as possible.
If you have IBD and are planning to become pregnant discuss the need for folic acid with your doctor. Folic acid has been shown to prevent neural tube defects in unborn children so it is very important to resolve any anemia and maintain adequate levels. Your doctor can help you develop a plan to do this should you decide to become pregnant.
IBD is hard on your body so nourish it with healthy eating habbits and supplements as directed to feed it in this fight.