State of Art of Oral Vitamin B12 (Cobalamin) in Biermer’s Disease (Pernicious Anemia)

Management of cobalamin deficiency with vitamin B12 injections is currently well codified, but new routes of vitamin B12 administration (oral and nasal) are being studied. In the setting of Biermer’s disease, two prospective controlled randomized studies, a recent systematic review by the Cochrane group and four prospective studies were found and provide evidence that oral vitamin B12 treatment may adequately treat cobalamin deficiency. The efficacy was particularly highlighted when looking at the marked improvement in serum vitamin B12 levels and hematological parameters, for example hemoglobin level, mean erythrocyte cell volume, reticulocyte count. The effect of oral cobalamin treatment in patients presenting with severe neurological manifestations has not yet been adequately documented. Oral cobalamin treatment avoids the discomfort, inconvenience and cost of monthly injections. 276 Japan Journal of Medicine 2018; 1(6): 276 284 . doi: 10.31488/jjm.1000128