B12 Vitamin Therapy

Vitamin B12 is important in DNA synthesis and blood formation. It is crucial in the creation of myelin, which is the insulation that protects nerve endings and facilitates communication between nerves. When you are deficient in B12, you will need therapy to regain the proper levels.

Intrinsic Factor

Symptoms of vitamin B12 deficiency include diarrhea, vomiting, fatigue, mental confusion, low red blood cell count, weakness and pallor. Pernicious anemia is probably the most well known cause of B12 deficiency. Pernicious anemia causes a lack of intrinsic factor. Intrinsic factor is an enzyme-like (unidentified) substance manufactured in the gut that binds with B12 to aid the body's absorption. With pernicious anemia, the body recognizes intrinsic factor as an invader and creates antibodies against it, eventually destroying the intrinsic factor, and even the stomach cells that produce it. Other reasons for B12 deficiency include a diet low in B12, chronic alcoholism, tape worm infection and abdominal surgery that interferes with production of intrinsic factor.

B12 Injections

For those with severely depleted B12 levels, physicians will recommend an injection of vitamin B12. This allows the body to rapidly absorb B12 and bypass any intrinsic factor deficiencies. For patients with pernicious anemia, their doctor might recommend a series of injections. This could be a lifelong treatment.

Oral B12

For vegans, or others with deficient B12 not related to intrinsic factor, supplementing B12 orally is the usual treatment. The patient will typically take 500 to 1,000 mcg daily. Oral B12 supplementation can also be a treatment strategy for those with pernicious anemia and intrinsic factor issues. Some doctors remain unaware that they can prescribe an initial injection of B12, followed by daily oral doses of 1,000 to 2,000 mcgs. Patients with intrinsic factor deficiency will only absorb about 2 percent of the dose, but your body only needs 3 to 4 mcgs of vitamin B daily to work efficiently.

Side Effects

Because the body needs B12, there are usually no side effects associated with therapy. However, some patients have had acneiform exanthema (small papules) break out on their chins, foreheads and upper back while using high doses of B12. Others on a high dose have reported a skin rash that resembles rosacea, but doesn't respond to treatments for rosacea. Both conditions resolved when patients discontinued B12 therapy.

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