Treatment for B12 and folate deficiencies frequently involves long-term or lifetime supplementation. Patients who lack intrinsic factor or have conditions causing general malabsorption require B12 injections or high-dose tablets. Folate/folic acid is an oral supplement. Doctors are recommending that all women contemplating having a child take folate supplements prior to and during pregnancy to ensure that they have a sufficient store for normal fetal development.
If a patient is deficient in both B12 and folate, he or she will require replenishment of both. If a patient with B12 deficiency only takes folic acid supplements, the macrocytic anaemia may be resolved but the underlying neuropathy (nerve damage) caused by the B12 deficiency will persist and may worsen dramatically and irreversibly.