Oral supplements work wonders in pernicious anaemia-related vitamin B12 deficiency

Oral supplementation with cyanocobalamin 1,000 μg/d helps treat vitamin B12 deficiency associated with pernicious anaemia (PA), reports a study.

Twenty-six patients with PA-related vitamin B12 deficiency received oral vitamin B12 supplementation, of whom 88.5 percent were no longer deficient after 1 months.

Significant improvements were noted in concentrations of plasma vitamin B12 (407 vs 148 pmol/L; p<0.0001), plasma homocysteine (13.5 vs 18.6 μmol/L; p<0.0001), and plasma methylmalonic acid (pMMA; 0.24 vs 0.56 pmol/L; p<0.0001) compared with baseline levels.

Such improvements were maintained throughout the 12-month follow-up period. None of the patients showed vitamin B12 deficiency by the end of follow-up. The median time to reverse initial vitamin B12 deficiency abnormalities had a range of 1 month for haemolysis to 4 months for mucosal symptoms.

This study enrolled individuals with incident vitamin B12 deficiency related to PA, the diagnosis of which was based on the presence of classical immune gastritis and of anti-intrinsic factor and/or antiparietal cell antibodies.

The researchers assessed vitamin B12 status by measuring total plasma vitamin B12, plasma homocysteine, and pMMA concentration, as well as urinary methylmalonic acid-to-creatinine ratio. Participants received oral cyanocobalamin 1,000 μg/d throughout the study duration. Clinical and biological vitamin B12 deficiency-related features were assessed over 1 year.

“The absorption of vitamin B12 is hindered in PA owing to intrinsic factor deficiency,” the researchers said. “Traditionally, intramuscular vitamin B12 injections were the standard treatment, bypassing the impaired absorption.”