A randomized, open labeled study comparing the serum levels of cobalamin after three doses of 500 mcg vs. a single dose methylcobalamin of 1500 mcg in patients with peripheral neuropathy

Abstract

BackgroundVitamin B12 deficiency has been associated with peripheral neuropathy, loss of sensation in the peripheral nerves, and weakness in the lower extremities. Methylcobalamin is the most effective analogue of vitamin B12 used to treat or prevent the complications associated with vitamin B12 deficiency. The current study aimed to compare the serum cobalamin levels after administration of two different regimes of methylcobalamin in peripheral neuropathy patients.MethodsThe present study was a prospective, randomized, comparative study. The study consisted of two parallel groups, group A (methylcobalamin 500 µg injection intramuscularly three times a week) and group B (methylcobalamin 1500 µg injection intramuscularly once a week). A control group of healthy volunteers was also included.ResultsA total of 24 patients (12 in each group) were included in the study. Five healthy volunteers were also included as a control in each group. At the end of treatment, serum cobalamin levels were significantly (P = 0.028) higher in group A (1892.08 ± 234.50) as compared with group B (1438.5 ± 460.32). The serum cobalamin levels in Group A healthy volunteers were also two times higher than that of group B (P = 0.056). Both the LANSS scale and DN4 questionnaire reported similar results at end of treatment.ConclusionsThe 500 µg methylcobalamin thrice weekly regime is more effective in increasing the serum cobalamin levels as compared to the 1500 µg methylcobalamin once weekly regime.

Local Administration of Methylcobalamin for Subacute Ophthalmic Herpetic Neuralgia: A Randomized, Phase III Clinical Trial

“…Methylcobalamin can attenuate neuropathic pain, which is accompanied by inhibition of intraepidermal nerve fiber loss and mitochondria impairment 36 . Clinical experience has shown that high‐dose methylcobalamin can relieve symptoms of neuropathy 37–39 . The results of this study indicated that local injections can directly deliver methylcobalamin to VZV‐damaged tissues, obtain neurological responses, and relieve pain, which is consistent with results from previous studies 25,26,40 …”

“…36 Clinical experience has shown that high-dose methylcobalamin can relieve symptoms of neuropathy. [37][38][39] The results of this study indicated that local injections can directly deliver methylcobalamin to VZV-damaged tissues, obtain neurological responses, and relieve pain, Figure 2. Mean pain score of subjects at each time point and multilevel mixed-effect model analysis.…”

Pain Fluctuations of Women with Subacute Herpetic Neuralgia During Local Methylcobalamin in Combination with Lidocaine Treatment: A Single-Blinded Randomized Controlled Trial

“…64 Clinical experience has shown that high-dose MeB can relieve symptoms of neuropathy. [65][66][67] The results of this study indicated that local injections can directly deliver MeB to VZV-damaged tissues, obtain neurological responses, and relieve pain, which is consistent with results from previous studies. 34,68 Widely used nerve blocks or regional anesthesia suggests that local administration is superior to systemic administration for peripheral nerve injury.…”

B12 as a Treatment for Peripheral Neuropathic Pain: A Systematic Review

“…At the end of the three-month study, both groups had a significant reduction in Leeds assessment of neuropathic symptoms and signs (LANSS) and Douleur Neuropathique (DN4) scores, but there was no significant difference between groups [39,40]. With respect to adverse events, the only complaints were injection site pain which affected four patients of those receiving thrice-weekly injections and one patient of those with once-weekly injections, as well as headache which affected one person in each group [19].…”