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Vitamin B12 Deficiency Anemia

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Treatment Overview

Vitamin B12 deficiency anemia is treated with supplements of vitamin B12. When the level of vitamin B12 has returned to normal, your body will produce more red blood cells and the symptoms will go away. However, most people need to take supplements for the rest of their lives to prevent the condition from returning. This is because the usual cause of vitamin B12 deficiency is poor absorption of the vitamin through the intestine. If you stop taking the supplements, your B12 level will fall again.

At first, you will get shots of vitamin B12 (100 to 1,000 micrograms [mcg]). You may get a shot every day for 1 week, then once a week for a month, and then once every month. Or your doctor may have you take pills (1,000 to 2,000 mcg a day) that contain a higher dose of vitamin B12 than a regular vitamin pill. You don't need to worry about getting too much vitamin B12, because your body will pass extra vitamin B12 out in the urine. Most people feel better within days of beginning treatment.

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If another condition is interfering with your body's ability to absorb vitamin B12, your doctor usually will treat it at the same time as the vitamin deficiency. For example, a bacterial infection in the bowels can be treated with antibiotics.

Often vitamin B12 deficiency anemia is not diagnosed until it is moderate to severe. This is because the anemia develops slowly and the symptoms can be subtle. If your anemia is severe, you may need a blood transfusion. In older adults who have transfusions, special care must be taken to avoid heart failure or pulmonary edema. Treatment may not completely correct the symptoms caused by damage to the brain and nerve cells.

Your doctor will recheck your vitamin B12 levels in a few months to make sure the treatment is working. You will need to take your shots or pills just as your doctor advises to keep the deficiency from returning. Most people need to take pills or shots for the rest of their lives.

Another form of treatment is a vitamin B12 nasal spray (Nascobal). But the nasal spray costs more than shots or pills and is not commonly used.

You can take steps at home to improve your health by eating a varied diet that includes meat, milk, cheese, and eggs, which are good sources of vitamin B12. Also eat plenty of foods that contain folic acid, another type of B vitamin. These include leafy green vegetables, citrus fruits, and fortified cereals.

What to Think About

The standard form of treatment for vitamin B12 deficiency anemia has been shots given into the muscle (intramuscular). But for many people, vitamin B12 pills can be as effective as shots. These vitamin B12 pills contain a higher dose of vitamin B12 than a regular vitamin pill. You don't need to worry about getting too much vitamin B12, because your body will pass extra vitamin B12 out in the urine. Pills are also less expensive and more convenient. If you have been getting shots, you might want to ask your doctor if you could switch to pills. You may need follow-up testing to make sure your body is absorbing the vitamin.

WebMD Medical Reference from Healthwise

Last Updated: December 19, 2008
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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