Oral treatment of vitamin B12 deficiency proven effective in subacute combined degeneration

Objective: Vitamin B12 deficiency due to malabsorption, nutritional deficiency or inborn errors of metabolism may lead to pernicious anemia, subacute combined degeneration (SCD) of the spinal cord and additional neurological symptoms. Randomized prospective studies have shown that pernicious anemia can be safely treated with oral vitamin B12, since trace amounts of oral vitamin B12 are absorbed even in complete absence of intrinsic factor. However, it is still common practice to treat SCD with intramuscular injections. We examplify oral treatment in a case of a 24-year-old female with SCD caused by vitamin B12 d…