Pernicious Anemia Medication
- Author: Paul Schick, MD; Chief Editor: Emmanuel C Besa, MD more...
Vitamin B12 is available for therapeutic use parenterally as either cyanocobalamin or hydroxocobalamin. Both are equally useful in the treatment of vitamin B12 deficiency, and they are nontoxic (except for rare allergic reactions). Theoretical advantages exist to using hydroxocobalamin because it is retained better in the body and is more available to cells; both chemical forms of cobalamin provide prompt correction.
Cobalamin is an essential vitamin. The inability to absorb adequate quantities of the vitamin from the diet leads to hematologic and neurologic complications.
Deoxyadenosylcobalamin and hydroxocobalamin are active forms of vitamin B12 in humans. Microbes, but not humans or plants, synthesize vitamin B12. Vitamin B12 deficiency may result from intrinsic factor (IF) deficiency (pernicious anemia), partial or total gastrectomy, or diseases of the distal ileum.
Cyanocobalamin may be administered either intramuscularly (IM) or subcutaneously (SC). At the initiation of therapy, large daily doses are administered in order to replenish body stores with cobalamin.
With certain hereditary defects of cobalamin, metabolism doses of cobalamin (eg, 1000 µg SC every week) may be required to obtain a response.
Deoxyadenosylcobalamin and hydroxocobalamin are active forms of vitamin B12 in humans. Vitamin B12 synthesized by microbes but not humans or plants. Vitamin B12 deficiency may result from intrinsic factor deficiency (pernicious anemia), partial or total gastrectomy, or diseases of the distal ileum. This agent is used to treat conditions caused by altered cobalamin metabolism that may cause secondary carnitine deficiency (ie, cobalamin C deficiency).
Multivitamins are used as dietary supplements.
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|Patient Condition||Methylmalonic Acid||Homocysteine|
|Vitamin B12 deficiency||Elevated||Elevated|
|Patient Condition||Stage I
No Intrinsic Factor
|Defect in ileum||Low||Low||Low||Low|