Cobalamin Deficiency in Elderly Patients: A Personal View

Table 5

Experience of oral cobalamin therapy for food-cobalamin malabsorption in the university hospital of Strasbourg, France.

Study characteristics (number of patients)	Therapeutic modalities	Results
Open prospective study of well-documented cobalamin deficiency related to food-cobalamin malabsorption (𝑛=10)	Oral crystalline cyanocobalamin: 650 μg per day during at least 3 months	– Normalization of serum cobalamin levels in 80% of the patients	[41]
		– Significant increase of hemoglobin (Hb) levels (mean of 1.9 g/dL) and decrease of mean erythrocyte cell volume (ECV) (mean of 7.8 fL)
		– Improvement of clinical abnormalities in 20% of the patients
		– No adverse effect
Open prospective study of low-cobalamin levels not related to pernicious anemia (𝑛=20)	Oral crystalline cyanocobalamin: between 1000 μg per day during at least 1 week	– Normalization of serum cobalamin levels in 85% of the patients	[42]
		– No adverse effect
Open prospective study of well-documented cobalamin deficiency related to food-cobalamin malabsorption (𝑛=30)	Oral crystalline cyanocobalamin: between 1000 and 250 μg per day during 1 month	– Normalization of serum cobalamin levels in 87% of the patients	[40]
		– Significant increase of Hb levels (mean of 0.6 g/dL) and decrease of ECV (mean of 3 fL); normalization of Hb levels and ECV in 54% and 100% of the patients, respectively
		– Dose effect: effectiveness dose of cobalamin ≥500 μg per day
		– No adverse effect
Open prospective study of low-cobalamin levels not related to pernicious anemia (𝑛=30)	Oral crystalline cyanocobalamin: between 1000 and 125 μg per day during at least 1 week	– Normalization of serum cobalamin levels in all patients with at least a dose of vitamin ≥250 μg per day	[43]
		– Dose effect: effectiveness dose of cobalamin ≥500 μg per day
		– No adverse effect
Open prospective study of low cobalamin levels related to pernicious anemia (𝑛=10)	Oral crystalline cyanocobalamin: 1000 μg per day during at least 3 months	– Significant increase of serum cobalamin levels in 90% of the patients (mean of 117.4 pg/mL)	[47]
		– Significant increase of Hb levels (mean of 2.45 g/dL) and decrease of ECV (mean of 10.4 fL)
		– Improvement of clinical abnormalities in 30% of the patients