Oral Cobalamin (Vitamin B12) Therapy: From Empiricism and Personal Experience to Evidence Based Medicine and Perspective of Recommendations and Guideline

In most countries, the classic treatment for cobalamin deficiency is based on parenteral administration as intramuscular injections in the form of cyanocobalamin and, more rarely, hydroxylor methylcobalamin [1]. In USA and UK, doses ranging from 100 to 1,000 μg per month (or every 2-3 months when hydroxocobalamin is given) are used for the duration of the patient’s life [2]. In France, treatment involves the administration of 1,000μg of cyanocobalamin per day for 1 week, followed by 1,000 μg per week for 1 month, followed by 1,000μg per month, again, normally for the remainder of the patient’s lifetime [3].