Comparison of the effectiveness of an oral combination of thiamine, pyridoxine, and cyanocobalamin with parenteral cyanocobalamin in adolescents with nutritional vitamin B12 deficiency

Abstract

Aims: Nutritional vitamin B12 deficiency remains a significant public health issue. This study aimed to compare the efficacy of an oral combination of thiamine, pyridoxine, cyanocobalamin, and parenteral cyanocobalamin treatment among adolescents with nutritional vitamin B12 deficiency. Methods: This retrospective study included patients aged 12-18 years who applied to University of Health Sciences Türkiye, Gülhane Training and Research Hospital General Pediatrics Polyclinic between 2018 and 2019, and serum vitamin B12 levels were measured before and after parenteral or oral combination of thiamine, pyridoxine, and cyanocobalamin treatment. Results: Of the subjects with post-treatment serum vitamin B12 levels above the target level of 200 pg/mL, parenteral cyanocobalamin was given to 34 patients with a median age of 16 years [interquartile range (IQR), 14 to 16 years], and girls (52.9%), and oral cyanocobalamin was given to 51 patients with a median age of 15 years (IQR, 13 to 16 years), and girls (58.8%). The mean serum vitamin B12 levels before parenteral and oral cyanocobalamin treatment were 150.32±6.49 pg/mL parenteral and 132.35±4.67 pg/mL in oral replacement groups (p>0.05). The mean serum vitamin B12 levels after parenteral and oral cyanocobalamin treatments were 566.0±62.77 pg/mL and 463.1±36.97 pg/mL, respectively (p>0.05). Both parenteral and oral cyanobalamin treatments caused a significant increase in serum vitamin B12 levels compared with before treatment (p<0.001 for both). Conclusions: In adolescents with nutritional vitamin B12 deficiency, an oral combination of thiamine, pyridoxine, and cyanocobalamin may be preferred to parenteral cyanocobalamin because it is non-invasive and provides an increase in serum vitamin B12 levels similar to parenteral cyanocobalamin treatment.

Keywords

• vitamin b12
• deficiency
• adolescent
• cyanocobalamin
• treatment