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Vitamin B12 deficiency treatment
Last reviewed: 20.10.2021
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Prevention is carried out in the case of gastrectomy and resection of the ileum.
The initial daily dose of vitamin B 12 is 0.25-1.0 mg (250-1000 μg) for 7-14 days. As an alternative scheme (with the ability of the body to store vitamin for a long time) use intramuscular injection of the drug in a dose of 2-10 mg (2000-10 000 μg) monthly. In most cases, therapy is carried out for life.
With a deficiency of transcobalamin II, a therapeutic response is achieved by the introduction of high doses of vitamin B 12, the content of cobalamin in serum should be maintained at a sufficiently high level. Adequate control of the disease is provided by intramuscular injection of 10 mg (10,000 μg) of vitamin B 12 2-3 times per week.
With methylmalonic aciduria and a violation of the synthesis of co-enzymes of cobalamin, vitamin B 12 is prescribed in a dose of 0.01-0.02 mg (10-20 μg) per day, but for some patients this dose is insufficient. It is possible to administer the drug by cordo-cenethesis.
When in the 12 -scarce megaloblastic anemia marked increase in the number of reticulocytes in the 3-4th day of the treatment, as much as possible - on the 6-8th day, the 20th day of treatment the number of reticulocytes is normalized. The content of reticulocytes is inversely proportional to the degree of anemia. In the bone marrow megalotsitoz begins to disappear within 6 hours after administration of vitamin B 12 and 72 hours after the start of treatment is completely absent. The decrease in the severity of neurologic symptoms is noted after 48 h, the lag in psychomotor development stops after a few months. Often in patients, residual neurologic changes are noted.
It must be remembered that as a result of vitamin A deficiency appointment of folic acid to patients with megaloblastic anemia in 12 leads to regression of symptoms only hematologic and neurologic in most cases progresses or remains unchanged, so its use is contraindicated.