Is There Any Point in Taking Oral B12 Supplements if You Have Pernicious Anemia?

Pernicious anemia (PA) is a condition caused by a deficiency in vitamin B12 and folate, which can be treated with supplements. However, the nature of the condition often means that oral B12 supplements may not be as effective as expected. This article explores the effectiveness of oral B12 supplements for those with pernicious anemia and provides insights based on scientific evidence and personal experiences.

The Role of Intrinsic Factor in B12 Absorption

Pernicious anemia arises from the lack of Intrinsic Factor (IF), a protein that facilitates the absorption of vitamin B12 in the small intestine. IF is produced by specific cells in the stomach lining, but these cells are destroyed due to atrophic gastritis, leading to B12 deficiency. The hydrophilic nature of B12 and its large molecular size make it difficult for it to passively absorb unless aided by active transport mechanisms such as IF.

The Effectiveness of Oral B12 Supplements

Despite the limitations, some argue that oral B12 supplements can still make a significant difference in managing pernicious anemia. A study from the British Journal of Hematology (2000) found that taking large doses of B12 orally can overcome the hurdle of B12 deficiency in PA patients. For instance, studies have reported that oral doses of up to 1000 mcg daily can be effective, and in some cases, even higher doses have shown promising results.

Personal Experiences and Research Trials

From personal trials and research, it has been observed that even high doses of oral B12 supplements may not be as effective as injections for those with pernicious anemia. Sublingual administration is one method that has been explored, where 5 mg tablets absorbed about 25 mcg over 120 minutes. Repeating doses resulted in visible effects equivalent to subcutaneous injections. Additionally, using L-methylfolate instead of folic acid reduced the required dose for minimum absorption from 2.4 mg to 4.4 mg.

Alternative Sources

In the case of pernicious anemia, natural sources like liver can provide significant amounts of vitamin B12. According to historical records, consuming about 150 grams of liver daily (raw or cooked) could potentially help, though larger doses were initially required to replenish B12 stores. Modern studies have shown that oral B12 doses of 1000 mcg and 2000 mcg are as effective as intramuscular administration in treating both hematological and neurological responses due to B12 deficiency.

Conclusion

While oral B12 supplements may not be the first choice for treating pernicious anemia due to the lack of intrinsic factor, they can still play a role in managing the condition, especially when used in high doses. Clinical evidence and personal experiences support that oral administration can be an effective alternative to injections, particularly for those who prefer non-invasive methods or for daily maintenance. However, it is crucial to consult a healthcare professional before making any significant changes to one's treatment plan.