TATALAKSANA ANEMIA NUTRISIONAL

dr. Amelya Augusthina Ayusari MGizi SpGK

Laboratorium Gizi
Fakultas Kedokteran
Universitas Sebelas Maret
OVERVIEW

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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

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1. OVERVIEW IRON DEFICIENCY ANEMIA
1.1 METABOLISM

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Consist of : intestinal absorption, transportation,
utilization, and elimination

 Regulation : Hepcidin ; produced at hepar

 Iron requirements are high -->erythropoiesis > hepcidin
low
 Inflammation --> hepcidin high

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IRON METABOLISM

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1. OVERVIEW IRON DEFICIENCY ANEMIA
HEPCIDIN

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IRON ABSORPTION

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 Males contain about 4,000 mg of iron 2,500 mg is
within erythrocytes; 1,000 mg is stored in splenic and

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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 7
1. OVERVIEW IRON DEFICIENCY ANEMIA

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The diagnosis of anemia is simple and objective: the World
Health Organization defines it as the decline in blood

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hemoglobin to a concentration below 13 g/dL in men and
12 g/dL in women

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1. OVERVIEW IRON DEFICIENCY ANEMIA

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1. OVERVIEW IRON DEFICIENCY ANEMIA
1.4 TREATMENT

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Food that rich of iron
Supplementatin

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1. OVERVIEW IRON DEFICIENCY ANEMIA
1.5 BAHAN MAKANAN SUMBER

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2. OVERVIEW FOLIC ACID DEFICIENCY ANEMIA
METABOLISM

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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.

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2. OVERVIEW FOLIC ACID DEFICIENCY ANEMIA

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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. 14

2.OVERVIEW FOLIC ACID DEFICIENCY ANEMIA

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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

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2.OVERVIEW FOLIC ACID DEFICIENCY ANEMIA

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Food that rich
 Treatment : oral folic acid (1 to 5mg daily) suffices to
treat folate deficiency

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2.OVERVIEW FOLIC ACID DEFICIENCY ANEMIA
BAHAN MAKANAN SUMBER

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3. OVERVIEW B12 VITAMIN DEFICIENCY ANEMIA

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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.

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3. OVERVIEW B12 VITAMIN DEFICIENCY ANEMIA

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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

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3.OVERVIEW B12 VITAMIN DEFICIENCY ANEMIA
CONSEQUENCE

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 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
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is left untreated
3.OVERVIEW B12 VITAMIN DEFICIENCY ANEMIA
BAHAN MAKANAN SUMBER

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 DAFTAR REFERENSI

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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-

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