Management of Vitamin B12 Deficiency: A Comparative Analysis of Intramuscular Injections versus Oral Medications

Regular monitoring of Vitamin B12 (VB12) levels and intake of supplements is crucial since their deficiency may cause serious health conditions including neurological and cardiovascular complications. Medical professionals recommend supplements in the form of oral tablets and parenteral replacement for patients who cannot obtain these nutrients through diet or who are deficient due to other health conditions. This study aimed to compare the efficacy of oral medications and parenteral administrations, especially intramuscular (IM) injections for managing VB12 deficiency. The patients diagnosed with confirmed VB12 deficiency (<211 pg/mL) were divided into two groups. One group received oral tablet (Mecobal 1000 mg); the other received VB12 injection (1000 mg) IM. The blood levels of both the groups were assessed after 6 months. The data were statistically analyzed to compare the efficacy of both routes. The mean age of oral and IM groups was 57 ± 10 years and 53 ± 11 years, respectively. The baseline serum VB12 values for the oral and IM groups were 158 pg/mL and 139 pg/mL, respectively (P = 0.01), and the mean VB12 values after treatment for the oral and IM groups were 301 pg/ml and 1416 pg/ml, respectively (P < 0.0001). The oral group observed a mean change of 143, while the IM group experienced a change of 1277 pg/ml (P < 0.0001). Our findings support the use of parenteral replacement over oral medications for the management of VB12.