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Medicine's Best Kept Secret?

Frank A. Lederle, MD

JAMA. 1991;265(1):94-95.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

THE TREATMENT of pernicious anemia with cobalamin is one of medicine's great success stories. However, the usual practice of giving the drug as an intramuscular injection has several drawbacks. Injections can be painful, difficult to provide for some patients who are elderly or living alone,¹ and costly if given by health professionals.² It is therefore not surprising that the search for an oral preparation began soon after cobalamin was isolated and introduced for parenteral use in 1948. Preparations containing oral intrinsic factor were tried, but antibody production caused some patients to become refractory and relapse.³ Other studies revealed that a small but constant proportion of an oral dose of cyanocobalamin was absorbed without intrinsic factor, so that by sufficiently increasing the dose, adequate absorption could be attained.^4,5

Promising results from early studies of oral cyanocobalamin therapy led to the use of increasingly larger doses, and several . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Medicine, Minneapolis Veterans Affairs Medical Center, University of Minnesota.

Footnotes
Presented at the annual meeting of the Society of General Internal Medicine, Washington, DC, May 2,1990.

Reprint requests to Division of General Internal Medicine (III-0), Department of Medicine, Minneapolis Veterans Affairs Medical Center, One Veterans Drive, Minneapolis, MN 55417 (Dr Lederle).

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