[Should we use oral replacement for vitamin B12 deficiency as the first option of treatment?].

Objective: Analyze whether the tablets available in Spain are useful for oral replacement in the treatment of vitamin B12 deficiency.

Methods: From June 2003 to December 2005, patients with vitamin B12 deficiency attended at the Internal Medicine Clinic, were offered the possibility of starting or switching to oral therapy. Clinical and biochemical responses were monitored at baseline and at 2, 4, 6, 12, 18 y 24 months of follow-up.

Results: Twenty-eight patients were included (55.6% women), with a mean age of 74.96 +/- 9.98 years. Twenty-three cases (82.1%) had pernicious anemia, and 5 were gastrectomized. Patients who switched from intramuscular to oral therapy (16 cases) showed no decrease in the mean values of hemoglobin and B12 levels during the follow-up. Patients who started on oral therapy showed an increase in the values of hemoglobin (from 9.9 +/- 2.8 g/dl to 13.5 +/- 1.1, p = 0.003) and vitamin B12 (from 118 +/- 50 pg/ml to 496 +/- 229, p = 0.001) as early as two months after baseline, maintaining the response during the follow-up. No patient refused oral therapy and no toxic effect attributed to oral therapy was recorded.

Conclusions: Oral replacement of vitamin B12 deficiency with the tablets available in Spain is safe, effective and acceptable to patients.