TATALAKSANA ANEMIA NUTRISIONAL

dr. Amelya Augusthina Ayusari MGizi SpGK

Laboratorium Gizi
Fakultas Kedokteran
Universitas Sebelas Maret
OVERVIEW

Topik
1. Anemia Defisiensi Besi/ iron deficiency
anemia
2. Anemia Defisiensi Asam Folat/folic acid
deficiency anemia
3. Anemia Defisiensi Vitamin B12/vitamin B12
deficiency anemia
1. OVERVIEW IRON DEFICIENCY ANEMIA
1.1 METABOLISM

Consist of : intestinal absorption,

transportation, utilization, and elimination

 Regulation : Hepcidin ; produced at hepar

 Iron requirements are high -->erythropoiesis
> hepcidin low
 Inflammation --> hepcidin high
IRON METABOLISM
1. OVERVIEW IRON DEFICIENCY ANEMIA
HEPCIDIN
IRON ABSORPTION
 Males contain about 4,000 mg of iron 2,500
mg is within erythrocytes; 1,000 mg is stored
in splenic and hepatic macrophages, and the
rest is distributed in various proteins such as
myoglobin, cytochromes or other ferroproteins.

 About 1–2 mg of iron is lost every day, through

skin and enteric desquamation and minor
blood losses.

 Loss is balanced by intestinal absorption.

 Iron recycling accounts for most of the iron

homeostasis in human
1. OVERVIEW IRON DEFICIENCY ANEMIA
The diagnosis of anemia is simple and
objective: the World Health Organization
defines it as the decline in blood hemoglobin to
a concentration below 13 g/dL in men and 12
g/dL in women
1. OVERVIEW IRON DEFICIENCY ANEMIA
1. OVERVIEW IRON DEFICIENCY ANEMIA
1.4 TREATMENT

Food that rich of iron

Supplementatin
1. OVERVIEW IRON DEFICIENCY ANEMIA
1.5 BAHAN MAKANAN SUMBER
2. OVERVIEW FOLIC ACID DEFICIENCY ANEMIA
METABOLISM

Folic acid deficiency can arise from multiple

causes including inadequate dietary intake

Heating during cooking destroys folic acid.

Folate is absorbed in the jejunum by active and

passive transport mechanisms across the
intestinal wall.
2. OVERVIEW FOLIC ACID DEFICIENCY ANEMIA

Prevent congenital disabilities especially neural

tube defects

Important in formation of several coenzymes in

many metabolic systems, particularly for purine
and pyrimidine synthesis, nucleoprotein
synthesis and maintenance in erythropoiesis

Folate like Vitamin B12 is a provider of 1-Carbon

residues for DNA and RNA synthesis

The potent form of folic acid is tetrahydrofolate.

2.OVERVIEW FOLIC ACID DEFICIENCY ANEMIA

Generally, serum folate levels <2 ng/mL are

considered deficient

Normal if > 4ng/ml are considered as normal.

Borderline levels between 2 to 4 ng/mL
2.OVERVIEW FOLIC ACID DEFICIENCY ANEMIA

Food that rich

 Treatment : oral folic acid (1 to 5mg daily)
suffices to treat folate deficiency
2.OVERVIEW FOLIC ACID DEFICIENCY ANEMIA
BAHAN MAKANAN SUMBER
3. OVERVIEW B12 VITAMIN DEFICIENCY ANEMIA

Vitamin B-12 is a crucial B vitamin.

It is needed for nerve tissue health, brain

function, and the production of red blood cells.

Cobalamin is another name for vitamin B-12.

3. OVERVIEW B12 VITAMIN DEFICIENCY ANEMIA

In the U.S., the National Institutes of Health

(NIH) recommend that teens and adults over
the age of 14 years should consume 
2.4 micrograms(mcg)/day

Pregnant women should be sure to consume

2.6 mcg)/day

Lactating women 2.8 mcg/day

3.OVERVIEW B12 VITAMIN DEFICIENCY ANEMIA
CONSEQUENCE

 symptoms, such as depression, confusion,

memory problems, and fatigue  not specific
enough
 Other symptoms of vitamin B-12 deficiency
include constipation, loss of appetite, and weight
loss.
 neurological changes, such as numbness and
tingling in the hands and feet. Some people may
have difficulty maintaining balance.
 Infants who lack vitamin B-12 may demonstrate
unusual movements, such as face tremors,,
feeding difficulties, irritation, and eventual growth
problems if the deficiency is left untreated
3.OVERVIEW B12 VITAMIN DEFICIENCY ANEMIA
BAHAN MAKANAN SUMBER
 DAFTAR REFERENSI

1. Waldvogel-Abramowski S, Waeber G, Gassner C,

Buser A, Frey BM, Favrat B, Tissot JD.Transfus
Med Hemother. 2014 Jun;41(3):213-21.
2. Kashif M. Khan; Ishwarlal Jialal . Folic Acid
(Folate) Deficiency. Treasure Island (FL): 
StatPearls Publishing; 2018 Jan-