Efficacy of oral cobalamin (vitamin B12) therapy

Abstract

Our experience and the present analysis support the use of oral cobalamin therapy in clinical practice.

The Syndrome of Food-Cobalamin Malabsorption: A Personal View in a Perspective of Clinical Practice

“…When FCM was identified as a major cause of cobalamin deficiency, the usefulness of oral supplementation in managing cobalamin deficiencies, which had previously been treated only by the parental route, was questioned and confirmed [28,29]. It should be noted from a practical point of view that only 1% of crystallin vitamin B12 (free) orally administered is absorbed by a passive diffusion mechanism (independently of intrinsic factor and cubilin) [7,28].…”

“…Since 1995, numerous clinical trials confirmed the non-inferiority of the oral route as compared to the parental route in the treatment of FCM, as evidenced by a normalisation of haematological abnormalities and regression of clinical symptoms, particularly neuropsychiatric manifestations, in the majority of patients [28,29]. It's important to keep in mind that early intervention is important to prevent permanent neurological damage.…”

“…It's important to keep in mind that early intervention is important to prevent permanent neurological damage. We have recently published an exhaustive review of the efficacy of oral cobalamin therapy in reference [29]. Table 3 summarizes the results of various not blinded, placebo-controlled trials that we conducted with oral cyanocobalamin in the context of FCM management [30][31][32].…”

“…All of the patients who were treated orally corrected their vitamin B12 levels and at least 80% corrected their hematological abnormalities. Moreover, half of the patients experienced a clinical improvement on oral treatment [29][30][31][32]34]. It is to note that the effect of oral cobalamin treatment in patients presenting with severe neurological manifestations has not yet been adequately documented [29].…”

“…Moreover, half of the patients experienced a clinical improvement on oral treatment [29][30][31][32]34]. It is to note that the effect of oral cobalamin treatment in patients presenting with severe neurological manifestations has not yet been adequately documented [29]. According to our experience and other published series (placebocontrolled trials), oral cyanocobalamin was also effective in pernicious anaemia [33][34][35][36].…”