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The purpose for giving B12 injections in patients with pernicious anemia
or other B12 deficiency syndromes is to restore supplies of this
essential vitamin and, then, to maintain the supply. Since the reason
for B12 deficiency (even in PA) is multifactorial, prescribing
replenisment on 1 or 3 months regular schedule, does not seem to be "the
best" recommendation for an universal application.  I believe that a EBM
scientist, when grading clinical trials, must determine what is the
clinical relevance of certain guidelines used for reference.
Dr. NM

Jon Brassey wrote:
>
> I've been asked by a number of clinicians about the frequency of B12 injections in patients with PA.  The current UK consensus appears to be injections every 3 months.  However, I've found one guideline (Canadian) that states every month.
>
> I hear the usual story from the clinicians - "we give injections every 3 months but the patients come back before 3 months is up asking for new injections".
>
> I've looked at the literature and can find very little 'evidence' to support either position.  I suppose a couple of questions:
>
> 1)  Anyone got any 'evidence'?
>
> 2)  Has anyone else come across this problem?
>
> I hope you can help - it's starting to 'bug' me!
>
> jon
>
> Jon Brassey
> TRIP, Support Manager
> Director, ATTRACT Wales
> http://www.tripdatabase.com
> Phone: 01495 765105
> Mamhilad House,
> Mamhilad Park Estate
> Pontypool NP4 0YP
> Wales