EFFICACY OF ORAL AND INTRAMUSCULAR VITAMIB B12 IN EARLY RESPONSEAND PREFERENCES OF PATIENTS

Abstract

BACKGROUND: Deficiency of vitamin B12 can be managed by oral substitution or
intramuscular injection of vitamin B12. When different administration routes are present, the
preference of patients should also be considered while treatment selection.
OBJECTIVE: The main objective of our study was to assess the preferences of patients towards
intramuscular injection or oral treatment of vitamin B12 supplementation, and to confirm the
efficacy of both treatment options in patients.
METHODOLOGY: This was a prospective clinical trial, conducted at tertiary care hospital for
a period of one year (June 2020 to May 2021). A total of 42 patients were selected for study.
Patients were randomly and equally allocated to oral (21 patients) or intramuscular treatment
groups (21 patients). In Group A, patients were given oral tablets of 1000μg cyanocobalamin,
while in Group B, 1000μg hydroxocobalamin injections were given to patients. Samples of
whole blood were extracted before starting of treatment, followed by 1, 2 and 4 weeks of
treatment, and were analyzed for serum vitamin B12 levels. Before and after treatment, the
patients were asked to fill questionnaire regarding preference of treatment options. SPSS 24.0.
was used for analysis. A p-value of <0.05 was considered as statistically significant.
RESULTS: Among all patients, the mean age was found as 46.3±3 years with majority were
including the females (63.3%). In Group A, serum vitamin B12 levels were 155 pmol/L (range
144-181) and Group B, it was 161 pmol/L (range 149-169). After 1 month of therapy, the level
of serum vitamin B12 level was increased significantly in Group A (368; range 295-419) and
Group B (2881 (range 1297-4418). Before starting of treatment, most of the preference was
given to oral route of administration. Eight patients changed their opinion after therapy.
CONCLUSION: There was significant difference in levels of vitamin B12 in both oral and
intramuscular treatment groups. Due to obvious effect in response to treatment, the opinion of
patients to select the routes of administration was also changed.