Megaloblastic anemia should be treated with both folic acid vitamin B12 because :

Answer is A (Folic acid alone causes improvement in hematologic in symptoms but worsening of neurological symptoms) Megaloblastic anemia may be caused by a deficiency of vitamin B12 (cobalamine) or deficiency of folate. Unless it is clearly established, which of the two deficienceis / folate or cobalamine) is the cause anemia treatment should include administration of both .folk acid and. vitamin Bp. If only folic acid is administered in a patient with mezaloblastic anemia due to vitamin BI2 deficiency, worseninz of neurological symptoms (cobalamine neuropathy) is seen despite an improvement in the hematological .symptoms (anemia) 'Although prompt hematologic response heralded by reticulocytosis follows the administration of folic acid, it should he cautioned that the hematologic symptoms of a vitamin B,2 deficiency anemia also respond to folate therapy. However Mate does not prevent and may even exacerbate the progression of neurological deficits typical of vitamin B12 deficiency states' Before large doses of folic acid are given, cobalamine deficiency must be excluded and if present corrected, otherwise cobalamine neuropathy may develop despite a response of the anemia of cobalamine deficiency to Palate therapy.