Causes of Megaloblastic Anemia based on Chinese medicine
Megaloblastic anemia is a type of anemia characterized by very large red blood cells. In addition to the cells being large, the inner contents of each cell are not completely developed. This malformation causes the bone marrow to produce fewer cells, and sometimes the cells die earlier than the 120-day life expectancy. Instead of being round or disk-shaped, the red blood cells can be oval. In traditional Chinese medicine, there are 5 contributing factors that lead to megaloblastic anemia.

1. Natural endowment
2. Improper diet
3. Food preference
4. Overstrain or fatigue
5. Serious illness or prolonged illness

Causes of Megaloblastic Anemia in western medicine
A combined deficiency of folate and cobalamin or vitamin B12 may be the reason behind megaloblastic anemia. Physicians order tests to identify the cause of the deficiency to decide on the course of the treatment and the supplements needed. Certain gastrointestinal diseases like celiac disease and alcohol abuse may impede the absorption of nutrients from food. Certain medication and barbiturates are known to interfere with the absorption of folic acid. A vegan who does not eat eggs or dairy products over a long period of time is susceptible to dietary insufficiency of cobalamin. Certain auto immune disorders resulting from thyroid problems or Addison's disease or type I diabetes may be the cause of pernicious anemia.

Megaloblastic anemia in childhood may be due to congenital disorders leading to vitamin B12 deficiency. Tapeworm infestation in the intestine can also interfere with the absorption of the vitamin. Even if a person eats food rich in folate, faulty cooking methods like using too much heat or water can destroy folic acid in food. Megaloblastic anemia causes could be as simple as increased folate requirement due to pregnancy and lactation. Skin diseases like psoriasis and exfoliative dermatitis could hike the demand for folic acid because of the rapid shedding of epidermal cells. Tropical sprue can lead to both folate and vitamin B12 deficiency.