Vitamin B12 deficiency from any cause except malabsorption from pernicious anemia or other GI disease
Child: 100 mcg IM or SC over = 2 wk; max 1-5 mg. Maintenance dose 60 mcg/month IM or SC.
Adult: 25 mcg PO qd as dietary suppositories, or 30-100 mcg SC or IM qd for 5-10 day depending on severity of deficiency. (IM recommended for pernicious anemia). Maintenance dose 100-200 mcg IM q month.
Diagnostic test for vitamin B12
Child, adult: 1 mcg IM qd × 10 day with diet low in vitamin B12 and folate. Reticulocytosis between day 3 and 10 confirms diagnosis of vitamin B12 deficiency.
Schilling test flushing dose
Child, adult: 1,000 mcg IM in 1 dose. |