Review of oral vitamin B12 (cobalamin) therapy

Emmanuel Andrès


Vitamin B12 (cobalamin) deficiency is particularly common in adults and elderlies (>15%). Management of cobalamin deficiency with cobalamin injections is currently well codified, but new routes of vitamin B12 administration (oral and nasal) are being studied, especially oral vitamin B12 therapy for food-cobalamin malabsorption. Three prospective randomized studies, a systematic review by the Cochrane group and five prospective cohort 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.


Vitamin B12, Cobalamin, sold neoplasm, Hematological disorders, Gammopathy of undetermied significant, renal failure, liver disease

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