Treatment for B12 and folate deficiencies frequently involves long-term or lifetime supplementation. Patients who lack intrinsic factor or have conditions causing general malabsorption usually require B12 injections. A few patients may absorb enough B12 from high-dose tablets to avoid regular injections. Folate is given as folic acid and is an oral supplement. In the UK doctors recommend that all women contemplating having a child should take folate supplements before and during pregnancy to ensure that they have sufficient stores for normal development of the baby.
After starting treatment - the anaemia improves after a few weeks. However, the neuropathy can take several months to improve and may never get fully better.
If a patient is deficient in both B12 and folate, he or she will require replenishment of both. If a patient with B12 deficiency takes only folic acid supplements, the anaemia may resolve but the underlying neuropathy (nerve damage) caused by the B12 deficiency will persist and may worsen dramatically and irreversibly.