Welcome to the med geeks podcast. This is Eric Gordon and we are going to be finishing up our conversation on anemia today.

If you haven't done so already, be sure and check out our two previous episodes on anemia.

Part one was microcytic anemia, part two normocytic. Today we are

finishing up with part three and that is macrocytic anemia. We're talking B12, we're talking folate. We're talking alcohol. We're going to get into the workup to figure out

what's causing a macro acidic anemia and of course we will talk about treatment as well.

So let's get into this. All right everybody just when you thought you couldn't get more anemia part three drops and we are going to be covering the final leg of anemia that is

macrocytic anemia today and just like all causes of anemia it's multi-factorial and there are many different causes that can lead to macrocytic anemia.

We're going to discuss them today with a particular focus on the most common causes and how to treat them.

So let's do it.

When you hear macrocytic anemia,

probably one of the first things that comes to your mind

is one of the most common causes, and that is B12

and or folate deficiency. So we'll start by talking about that. These are

going to produce a megaloblastic anemia. Megaloblastic anemia is a type of

macrocytic anemia in which the cause of the larger than should be red blood cell is that the nucleic acid synthesis is impaired.

And basically what happens since DNA synthesis is halted, the cell continues to grow larger

but cell division does not occur until later.

So you wind up with these larger than normal cells.

This is frequently caused by B12 or folate deficiency, but could also be a copper deficiency, as well as some drugs that impair the production of purines and pyridines.

These include allopurinol antac, including p p p p p p pis

methatrixate antiretroviral medications, some seizure meds, and there's a lot more.

Humans really

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