FeatureVitamin B12 (Cobalamin) DeficiencyFolate (Vitamin B9) Deficiency
Primary Unique RoleNeurological function (myelin sheath)Neural tube development (in fetus)
Primary SourcesAnimal productsLeafy greens, legumes, fortified foods
Body StoresLarge (Years)Small (Months)
AbsorptionTerminal Ileum (Requires Intrinsic Factor)Duodenum/Jejunum (No Intrinsic Factor)
Key Unique CausesPernicious anemia, vegan diet, gastric surgeryPoor diet, alcoholism, pregnancy needs
Neurologic SymptomsPRESENT (Paresthesias, gait issues, cognitive changes)ABSENT
Key Lab MarkerElevated Methylmalonic Acid (MMA)Normal Methylmalonic Acid (MMA)
Treatment DangerFolate alone masks anemia, allows neuro damage to progressLess critical interaction (though diagnosis is key)