Oral treatment of pernicious anemia with high doses of vitamin b12 without intrinsic factor

Q: Can you absorb B12 without intrinsic factor?

A small amount of vitamin B12 is absorbed by passive diffusion without intrinsic factor.

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Can pernicious anemia be treated with oral B12?
Why is oral administration of vitamin B12 not effective as a treatment for pernicious anemia?
Can you absorb B12 without intrinsic factor?
Can you have pernicious anemia without intrinsic factor antibodies?

Abstract

A large group of patients with pernicious anemia has been treated with vitamin B12 for periods as long as forty months. Parenterally administered B12 was as effective as refined liver extract in producing and maintaining clinical and hematologic remission. No evidence was found that patients with uncomplicated pernicious anemia need any therapy other than vitamin B12. Orally administered vitamin B12 was effective in the treatment of pernicious anemia provided that the oral dose was about 100 times the amount which was adequate when given parenterally. Until the adequacy of oral dosage schedules has been demonstrated patients with pernicious anemia should receive parenteral therapy. An intramuscular injection of 45 μg. of vitamin B12 given every six weeks appeared to be adequate for satisfactory maintenance therapy and protected against hematologic and neurologic relapse. Vitamin B12 seems preferable to liver extract in the treatment of pernicious anemia because it causes less discomfort at the site of injection, does not give rise to untoward reactions and is less expensive than liver extract.

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Article Info

Footnotes

☆This investigation was in part carried out under contract number AT (30-1)—1208 between the Atomic Energy Commission and the Johns Hopkins University, and in part supported by research grants from the National Vitamin Foundation and the Squibb Institute for Therapeutic Research.

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DOI: https://doi.org/10.1016/0002-9343(52)90283-0

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Can pernicious anemia be treated with oral B12?

For long-term maintenance therapy, oral vitamin B12 replacement can be effective in patients with pernicious anemia.

Why is oral administration of vitamin B12 not effective as a treatment for pernicious anemia?

This belief is still being propagated, as this quote from an article published recently attests: “Pernicious anemia is caused by inadequate secretion of gastric intrinsic factor necessary for vitamin B₁₂ absorption and thus cannot be treated with oral vitamin B₁₂ supplements; rather, vitamin B₁₂ must be administered ...

Can you absorb B12 without intrinsic factor?

A small amount of vitamin B₁₂ is absorbed by passive diffusion without intrinsic factor.

Can you have pernicious anemia without intrinsic factor antibodies?

A negative test result does not necessarily mean that a person does not have pernicious anemia. As many as half of those affected will not have IF antibodies.