Comparison Between Different Intramuscular Vitamin B12 Supplementation Regimes: a Retrospective Matched Cohort Study

Abstract

In this study, a shorter injection regime is probably not sufficient to treat a vitamin B deficiency. An injection regime with 6 injections recovered all vitamin B deficiencies biochemically. MMA levels cannot recover spontaneously over time without additional im injection regime.

Improved testing for vitamin B12 deficiency: correcting MMA for eGFR reduces the number of patients classified as vitamin B12 deficient

“…Diagnosing vitamin B 12 deficiency is not without difficulty; even a positive response to therapy is no absolute proof. 19 Supplementation itself, regardless of the actual vitamin B 12 status, has been shown to improve clinical symptoms related to vitamin B 12 deficiency, such as fatigue in extreme or milder form, tingling or prickly fingers and reduced attention span. 9 Given the limitations of current testing for vitamin B 12 deficiency and because its administration is inexpensive and fairly innocent, many clinicians have a low threshold for prescribing vitamin B 12 supplementation, usually by intramuscular injection to bypass issues with absorption.…”

“…Therefore, in this range, an additional measurement of MMA serum concentration is performed (reflex test), where MMA concentrations above 430 nmol/L indicate vitamin B 12 deficiency. 9,19 The outcome of this two-step algorithm will in this paper be considered as routine diagnostic algorithm (RDA). Although extreme vitamin B 12 and MMA concentrations beyond the measuring range, i.e.…”

“…The clinical impact of correcting MMA concentrations for eGFR is reflected in the proportion of patients currently being diagnosed of being vitamin B 12 deficient but who potentially are not vitamin B 12 deficient according to the eGFR-corrected MMA concentrations and a uniform MMA cut-off level. 9,19 The outcome of this two-step algorithm will in this paper be considered as routine diagnostic algorithm (RDA). Although extreme vitamin B 12 and MMA concentrations beyond the measuring range, i.e.…”