Anaemia: cobalamin deficiency may be treated orally.

Clinical bottom line (level 4)

  1. Patients with pernicious anaemia or malabsorption, were successfully treated with oral cobalamin.
Berlin et al: Acta Medica Scandinavia 1968; 184: 247-258
Expires June 2003

The study

Case series with ?objective ?blinded outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: three medical centres, Sweden

64 patients (aged ?, ?% male) established vitamin B-12 deficiency (due to pernicious anaemia or malabsorption)
Received oral vitamin B-12, 500 or 1000 µ g daily.

95% followed for 36 months
Outcomes studied:
  • normal haemoglobin
  • normal B 12

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    normal haemoglobin 36 months 64/64 100%
    (95% to 100%)
    normal B 12 36 months 55/64 86%
    (77% to 94%)

    Comments

    1. Few studies have addressed the benefits of oral cobalamin- none have compared it to intramuscular injections.
    2. Amazing how long this has been unresolved.

    Citation

    1. Berlin H, Berlin R, Brante G: Oral treatment of pernicious anemia with high dose vitamin B 12 without intrinsic factor. Acta Medica Scandinavia 1968; 184: 247-258
    Search Terms: reference in review article
    Contributor: Chris Ball and Clare Wotton, June 2000
    Reviewer: Daniel Sontheimer

    Clinical Question.
    Patient vitamin B-12 deficiency
    Intervention or Exposure oral cobalamin
    Outcome B-12 return to normal