Oral vitamin B12 treatment is effective for children with nutritional vitamin B12 deficiency

Abstract

Data from this study indicate that oral vit-B12 (1000 μg) for 4 months is effective, giving clinicians more choice, for treatment of children with nutritional vit-B12 deficiency. However, despite this high dose, lower levels were achieved in older children indicating the necessity of dosage adjustment in accordance with body weight.

Efficacy of oral methylcobalamin in treatment of vitamin B12 deficiency anemia in children

“…A study among 47 vitB12-deficient children showed an effective response with 1,000 g oral vitB12 as intermittent therapy for 4 months. 7 A few other small studies and case reports among children also supported oral vitB12 as a treatment option, even in cases of selective vitB12 malabsorption. 8,9 Since our study included children aged 6 months-18 years, instead of using a fixed-dose vitB12 formulation for all, we used a daily dose per unit body weight of methylcobalamin.…”

“…A limited number of pediatric studies also have documented an adequate response. A study among 47 vitB12‐deficient children showed an effective response with 1,000 μg oral vitB12 as intermittent therapy for 4 months . A few other small studies and case reports among children also supported oral vitB12 as a treatment option, even in cases of selective vitB12 malabsorption …”

“…Hb showed a mean increase of 2.89 g/dl at 1 month (P < 0.001) with 24 of 28 (85.7%) patients having Hb exceeding 10 g/dl; however, this value was still lower than the age-appropriate cut-off for defining anemia in 19 (67.8%) patients, suggesting that a longer duration of therapy should be used, as in other studies. [4][5][6][7] Hcy is increased in both FA and vitB12 deficiencies, but serum MMA is increased in vitB12 deficiency only. MMA and Hcy levels together are considered to be more sensitive biomarkers for functional vitB12 status.…”

“…2,3 Conventionally, vitB12 deficiency is treated parenterally. However, several recent case series and controlled studies in adults 4-6 and fewer Abbreviations: CBC, complete blood count; FA, folic acid; Hb, hemoglobin; Hcy, homocysteine; HoloTC, holotranscobalamin; MA, megaloblastic anemia; MCV, mean corpuscular volume; MMA, methylmalonic acid; PS, peripheral smear; vitB12, vitamin B12 studies in children [7][8][9] have demonstrated the efficacy of oral regimens.…”

Hibiscus sabdariffa increases hydroxocobalamin oral bioavailability and clinical efficacy in vitamin B12 deficiency with neurological symptoms

“…Two forms of vitamin B 12 are usually used, cyanocobalamin (Cnbl) and hydroxocobalamin (Hdrx). The route of administration of vitamin B 12 therapies has been extensively studied in young [21], adult and elderly patients [22][23][24].…”