Efficacy of short-term oral cobalamin therapy for the treatment of cobalamin deficiencies related to food-cobalamin malabsorption: a study of 30 patients.
BACKGROUND
It has been suggested that oral cobalamin (vitamin (B12)) therapy may be an effective therapy for treating cobalamin deficiencies related to food-cobalamin malabsorption. However, the duration of this treatment was not determined.


METHODS
In an open-label, nonplacebo study, we studied 30 patients with established cobalamin deficiency related to food-cobalamin malabsorption, who received between 250 and 1000 microg of oral crystalline cyanocobalamin per day for at least 1 month.


METHODS
Blood counts, serum cobalamin and homocysteine levels were determined at baseline and during the first month of treatment.


RESULTS
During the first month of treatment, 87% of the patients normalized their serum cobalamin levels; 100% increased their serum cobalamin levels (mean increase, +167 pg/dl; P < 0.001 compared with baseline); 100% had evidence of medullary regeneration; 100% corrected their initial macrocytosis; and 54% corrected their anemia. All patients had increased hemoglobin levels (mean increase, +0.6 g/dl) and reticulocyte counts (mean increase, +35 x 10(6)/l) and decreased erythrocyte cell volume (mean decrease, 3 fl; all P < 0.05).


CONCLUSIONS
Our findings suggest that crystalline cyanocobalamin, 250-1000 microg/day, given orally for 1 month, may be an effective treatment for cobalamin deficiencies not related to pernicious anemia.
Andrès
E
E
Department of Internal Medicine, Diabetes and Metabolic Disorders, Hôpitaux Universitaires de Strasbourg, France. emmanuel.andres@chru-strasbourg.fr
Kaltenbach
G
G
Noel
E
E
Noblet-Dick
M
M
Perrin
A-E
AE
Vogel
T
T
Schlienger
J-L
JL
Berthel
M
M
Blicklé
J F
JF
D000368:Aged; D000369:Aged, 80 and over; D001772:Blood Cell Count; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008286:Malabsorption Syndromes / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000188:drug therapy* / Q000209:etiology
D006454:Hemoglobins; D006710:Homocysteine; D014805:Vitamin B 12