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Pathophysiology of vit B12 and folate deficiency.

Folic acid:

Tetra Hydro Folic Acid (THFA) is carrier of One Carbon groups like 

  • methyl (CH3).
  • Methylene (CH2)
  • Methenyl ( CH)
  • Formyl (CHO)
Purine carbon source:
  1. C2 by Formyl THFA
  2. C8 by Methenyl THFA
Thymine Carbon source:
Deoxy URIDINE MONO PHOSPHATE is reduced by methyl group from methyl Tetrahydrofolate to form THYMIDINE MONO PHOSPHATE.

Cobalamin:

Methylene THFA to Methyl THFA is irreversible reaction.
B12 receives Methyl from Methyl THFA to release THFA which is converted to Methylene THFA which can be used in Thymine synthesis.
Hence 
Deficiency in Folic acid / cobalamin
⇓
Deficiency in Nucleotides formation 
⇓
Deficiency in DNA 🧬 replication & repair
⇓
Arrest of maturity→Megaloblast
+
Defective hematopoiesis→Anemia

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