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Oral vitamin B-12 may replace hydroxocobalamin injections in treating RYGB patients

07 Aug 2018
Healthy people do not necessarily need to consume dietary supplements.

Oral vitamin B-12 supplementation yields similar efficacy to that of hydroxocobalamin injections, according to a recent study. This suggests that oral supplementation can be used to replace hydroxocobalamin injections in the treatment of Roux-en-Y gastric bypass (RYGB) patients with low values of serum vitamin B-12.

The investigators conducted a randomized controlled trial of RYGB patients with subnormal serum B-12 concentrations. One group (IM B-12) received bimonthly intramuscular hydroxocobalamin injections (2,000 µg as loading dose and 1,000 µg at follow-up) for 6 months. The other group (oral B-12) received daily doses of oral methylcobalamin (1,000 µg).

The investigators determined serum vitamin B-12 at baseline (T0) and at 2 (T1), 4 (T2) and 6 months (T3) after the start of treatment. They also measured concentrations of the secondary markers methylmalonic acid (MMA) and homocysteine (Hcy) at T0 and T3.

A total of 50 patients were randomly assigned to either IM B-12 (n=27) or oral B-12 (n=23). The respective median vitamin B-12 concentrations at T0 were 175 pmol/L (range, 114–196 pmol/L) and 167 pmol/L (range, 129–199 pmol/L).

Vitamin B-12 returned to normal levels in all participants, and no significant between-group difference was seen in vitamin B-12.

Both IM B-12 and oral B-12 groups showed significantly lower MMA (p<0.001 and p<0.001, respectively) and Hcy (p=0.03 and p=0.045, respectively) concentrations after 6 months. There was no significant between-group difference for both MMA (p=0.53) and Hcy (p=0.79) at 6 months.

Patients often develop a vitamin B-12 deficiency following RYGB, according to the investigators.

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Most Read Articles
21 hours ago
Use of potassium citrate and thiazides appears to improve health-related quality of life (HRQOL) among stone formers across all Wisconsin Stone Quality of Life (WISQOL) domains without increasing the likelihood of gastrointestinal complaints and fatigue or sexual complaints, respectively, reports a study.
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2 days ago
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Yesterday
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