The patient has combination of
vitamin B12 + anaemia- so treatment needs be well-timed and coordinated, otherwise absorption gets affected
Low Hb + RBC -Anaemia
Low / abnormal TIBC - suggest iron metabolism anaemia
B12 deficiency- can cause megaliblastic anaemia
Iron and zinc should spaced
Yes
Iron and zinc compete for absorption in intestine
Taking together-reduce effectiveness of both
Keep 2-3 hours gap
Ideal supplements schedule
Iron supplements ( Morning empty stomach)
Take with lemon water
Avoid with - tea , coffee,
calcium, milk
Evening -after food
Zinc
Bedtime- vitamin B12 nerokind or methyl cobalamin
Add in diet :
Non veg : chicken,
liver, meat, egg
Veg : beet root , pomegranate, jaggery,spinach , dates
Combine with vitamin C foods ( lemon , amla )
For RBC
Folate foods like green leafy, legumes