Vitamin B12 Deficiency Treatment Options

Vitamin B12 deficiency treatment can be effective with a number of methods, depending on the cause and severity of a patients B12 deficiency.

Among the supplements available are vitamin B12 injections, oral pill, sublingual pill, strip or liquid (liquid forms are designed to be absorbed in the mouth rather than swallowed for stomach absorption), or intranasal spray.

The supplements are also available in a number of B12 forms such as hydroxycobalaminmethylcobalamin, or cyanocobalamin.

Historically, the most common method of B12 deficiency treatment has been vitamin B12 injections.

B12 injections became the preferred method of physicians and clinicians because the most common causes of B12 deficiency stem from an inability of the digestive system to absorb adequate amounts of B12 from foods.

For example a common cause of vitamin B12 deficiency is pernicious anemia, a condition that reduces a substance in the digestive tract called intrinsic factor.

The absence of intrinsic factor impairs the ability of the stomach and intestines to absorb B12 from foods.

Since B12 injections are given intramuscularly they do not rely on the presence of intrinsic factor or the digestive system for absorption.

Another benefit of the injection is that it has high absorption rates and it can get adequate amounts of B12 into the blood quickly, expediting the replenishment and healing process.

Although B12 deficiency treatment schedules may vary, typically the treatment will start with high dose loading for the first couple of weeks and then monthly maintenance shots.

Depending on the cause of deficiency, monthly maintenance shots may need to continue for the duration of the patient’s life.

Patients can easily self-administer the B12 injections using the same type of fine gauge needles and syringes used by diabetics to inject insulin.

Vitamin B12 injections are safe, effective and inexpensive however there are a few downsides.

The injections can be painful and if the patient is not comfortable with self administering the shots, therapy costs can rise.

READ : Which Vegan Foods Contain the Most Vitamin B12?

Oral supplements for b12 deficiency treatment have become increasingly recognized as a sufficient means of replenishment when given in large doses.

In fact, studies have shown since the late 1960’s that the oral pill has equal effectiveness to that of injections in the treatment of B12 deficiency conditions including pernicious anemia.

When large oral doses of are given, it is believed that the vitamin is absorbed “en masse” through a pathway that does not require the presence of intrinsic factor or an intact ileum.

Though the daily requirement of vitamin B12 is approximately 2 mcg, oral mega-doses of 1,000 to 2,000 mcg  (1 to 2 mg) must be administered due to varying absorption rates in dosages less than 500 mcg.

A number of studies have shown that daily oral doses of 2mg are actually more effective than 1mg injections administered monthly.

After 3 months of treatment, patients in oral group of these studies showed higher serum vitamin B12 levels and lower methylmalonic acid levels than that of the injection group.

Oral B12 regimens are daily versus monthly with injections. However, the method is well tolerated by patients and is also safe and effective.

Alternative Methods for B12 Deficiency Treatment

In addition to the more common B12 injections and pills, other forms of effective B12 deficiency treatment are available such as sublingual and intranasal.

While there have been claims that these methods offer a more direct and superior route of administration than the B12 pill, there have been no studies that substantiate the claims.

Intranasal B12 is administered via nasal spray or gel while sublingual B12 supplements are absorbed through the tongue.

Sublingual supplements are available in several different forms such as lozenges, strips or liquids.

These methods presume that absorption through the tongue or nasal passage is a more direct and effective method than the swallowed pill.

While the effectiveness of both methods are proven, studies have shown no significant difference in absorption for sublingual, intranasal and oral supplements.

The difference in B12 deficiency treatment therefore lies on patient preference.

Patients should always get the advise of a health professional and have follow-up test to ensure the chosen method is adequate therapy. 

While all of the mentioned forms of B12 deficiency treatment have shown efficacy in the treatment of B12 deficiency, no single regimen fits all situations.

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