THE VITAMIN B12 AND FOLATE PATHOLOGY INVESTIGATION
THE INVESTIGATION OF ERRORS IN PATHOLOGY TESTS
FOR VITAMIN B12 AND FOLATE DEFICIENCY
BY MEANS OF MEDICAL EXPERIMENTS
B12 AND FOLATE INFORMATION
B12 EXPERT OPINION
B12 Expert Opinion
Treatment
Oh and Brown, reference DA01:
Because most clinicians are generally unaware that oral vitamin B12 therapy is effective,17 the traditional treatment for B12 deficiency has been intramuscular injections. However, since as early as 1968, oral vitamin B12 has been shown to have an efficacy equal to that of injections in the treatment of pernicious anemia and other B12 deficiency states.9,17-19

 

Nexo et al, reference DA03:
Once cobalamin deficiency has been diagnosed, the cause for the deficiency should be sought and the patient should be treated for life.

 

Klee, reference DA06:

 

Kuzminski, reference FA01:

 

Nyholm, reference FA03:

 

Higdon, reference GA06:
Treatment of pernicious anemia generally requires injections of vitamin B12 to bypass intestinal absorption. High-dose oral supplementation is another treatment option, because consuming 1,000 mcg (1 mg)/day of vitamin B12 orally should result in the absorption of about 10 mcg/day (1% of dose) by passive diffusion. In fact, high-dose oral therapy is considered to be as effective as intramuscular injection.

 

British Columbia Guidelines and Protocols Advisory Committee, reference GA10
Oral replacement of vitamin B12 is the treatment of choice in most cases, including pernicious anemia. Patients with significant neurological symptoms, however, should receive initial intramuscular injections of 1000 μg vitamin B12, followed by oral doses of 1000-2000 μg/day. The duration of therapy depends on the cause of deficiency. In the case of pernicious anemia, treatment is life-long. Early treatment of vitamin B12 deficiency is particularly important because neurologic symptoms may be irreversible.

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