Oral Vitamin B12 for the treatment of Vitamin B12 deficiency: A Systematic Review
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This systematic review assessed the effectiveness of oral versus parenteral vitamin B12 for treating vitamin B12 deficiency. The review identified 3 randomized controlled trials that met the inclusion criteria. The evidence from these trials shows that high daily doses of oral vitamin B12 (1000 μg) are as or more effective at producing hematological and neurological responses as parenteral administration. Lower doses of oral vitamin B12 (50 μg daily) also produce a hematological response compared to placebo but may not produce a significant neurological response. Very low doses of oral vitamin B12 (10 μg) do not produce significant hematological or neurological responses compared to placebo.
![Oral Vitamin B12 for the treatment of Vitamin B12 deficiency: A Systematic Review Josep Vidal-Alaball 1 , Christopher C Butler 1 , Kerry Hood 1 , Rebecca Cannings 1 , Andrew McCaddon 1 , Alexandra Papaioannou 2 1 Department of General Practice, University of Wales College of Medicine 2 McMaster University, Canada Aims To assess the effectiveness of oral vitamin B12 versus parenteral vitamin B12 for vitamin B12 deficiency. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Figure 1 . Patients on oral high-dose cyanocobalamin in Sweden 1990-2000 7 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],References 1. van Walraven C, Naylor C. Use of vitamin B12 injections among elderly patients by primary care practitioners in Ontario. Canadian Medical Association Journal 1999;161:146-9. 2. Rickes E, Brink N, Koniuszy F, Wood T, Folkers K. Crystalline vitamin B12. Science 1948;107:396. 3. Spies T, Stone R, Lopez G, Milanes F, Toca R, Aramburu T. Vitamin B12 by mouth in pernicious and nutritional macrocytic anaemia and sprue. Lancet 1949;2:454-6. 4. Ross G, Mollin D, Cox E, Ungley C. Hematologic responses and concentration of vitamin B12 in serum and urine following oral administration of vitamin B12 without intrinsic factor. Blood 1954;9:473-88. 5. Berlin H, Berlin R, Brante G. Oral treatment of pernicious anemia with high doses of vitamin B12 without intrinsic factor. Acta Medica Scandinavica 1968;184(4):247-58. 6. Berlin R, Berlin H, Brante G, Pilbrant A. Vitamin B12 body stores during oral and parenteral treatment of pernicious anaemia. Acta Medica Scandinavica 1978;204(1-2):81-4. 7. Norberg B. Oral high-dose cyanocobalamin - a contagious concept. Rondel , 2001. 8. Lederle FA. Oral cobalamin for pernicious anemia. Medicine's best kept secret? Journal of the American Medical Association 1991;265(1):94-95. 9. Kuzminski AM, Del Giacco EJ, Allen RH, Stabler SP, Lindenbaum J. Effective treatment of cobalamin deficiency with oral cobalamin. Blood. 1998;92(4):1191-8. 10. Seal EC, Metz J, Flicker L, Melny J. A randomized, double-blind, placebo-controlled study of oral vitamin B12 supplementation in older patients with subnormal or borderline serum vitamin B12 concentrations. Journal of the American Geriatrics Society. 2002;50(1):146-51.](https://image.slidesharecdn.com/posterwalesprimarycaresymposiumjvidalalaball-091122185052-phpapp01/85/Oral-Vitamin-B12-for-the-treatment-of-Vitamin-B12-deficiency-A-Systematic-Review-1-320.jpg)
