Treatment of vitamin B12 and folate deficiencies
- Stanley L Schrier, MD
Stanley L Schrier, MD
- Editor-in-Chief — Hematology
- Section Editor — Myeloproliferative Disorders; Red Blood Cell Disorders
- Professor of Medicine
- Stanford University School of Medicine
This topic reviews the treatment of vitamin B12 and folate deficiencies, including the route and duration of therapy, monitoring, and expected hematologic and neurologic response.
Separate topic reviews discuss the clinical manifestations, diagnosis, causes, and pathophysiology of these deficiencies:
●Clinical presentation and diagnosis – (See "Clinical manifestations and diagnosis of vitamin B12 and folate deficiency".)
●Causes and pathophysiology – (See "Causes and pathophysiology of vitamin B12 and folate deficiencies".)
GENERAL PRINCIPLES OF TREATMENT
All individuals with documented vitamin B12 and/or folate deficiency should be treated, unless there is a strong reason not to do so (eg, palliative care setting or patient refusal). A number of general principles apply to both vitamin B12 and folate deficiency. These are outlined below and in a 2014 guideline on the diagnosis and treatment of vitamin B12 and folate deficiency from the British Committee for Standards in Haematology .To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- GENERAL PRINCIPLES OF TREATMENT
- Urgency of correction
- Route of administration
- Available therapeutic preparations
- Duration of therapy
- Need for additional testing
- Adverse effects/overdose
- VITAMIN B12
- Prevention of vitamin B12 deficiency
- Treatment of vitamin B12 deficiency
- Individuals without documented vitamin B12 deficiency
- Prevention of folate deficiency
- Treatment of folate deficiency
- Individuals without documented folate deficiency
- ASSESSING AND MONITORING RESPONSE TO TREATMENT
- Typical response
- Intensity of and duration of monitoring
- Approach to lack of response
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS