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The evidence derived from these limited studies suggests that 2000 mcg doses of oral vitamin B12 daily and 1000 mcg doses initially daily and thereafter weekly and then monthly may be as effective as intramuscular administration in obtaining short term haematological and neurological responses in vitamin B12 deficient patients.

Low quality evidence shows oral and IM vitamin B having similar effects in terms of normalising serum vitamin B levels, but oral treatment costs less. We found very low-quality evidence that oral vitamin B appears as safe as IM vitamin B. Further trials should conduct better randomisation and blinding procedures, recruit more participants, and provide adequate reporting. Future trials should also measure important outcomes such as the clinical signs and symptoms of vitamin B deficiency, health related-quality of life, socioeconomic effects, and report adverse events adequately, preferably in a primary care setting.

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