What are the potential side effects of vitamin B-12 supplements. How much vitamin B-12 do you need daily. Which foods are rich in vitamin B-12. How can you manage B-12 supplement side effects.

Understanding Vitamin B-12 and Its Importance

Vitamin B-12, also known as cobalamin, is a crucial nutrient that plays a vital role in various bodily functions. It’s essential for DNA synthesis, red blood cell formation, and maintaining a healthy nervous system. While most people obtain sufficient B-12 through their diet, some individuals may require supplements to meet their nutritional needs.

What makes vitamin B-12 unique? Unlike many other vitamins, B-12 is primarily found in animal-based foods, making it challenging for vegetarians and vegans to obtain adequate amounts solely through their diet. Additionally, certain health conditions and medications can interfere with B-12 absorption, potentially leading to deficiency.

Key Functions of Vitamin B-12

• DNA synthesis and cell division
• Red blood cell formation
• Nervous system maintenance
• Energy production
• Homocysteine metabolism

Common Sources of Vitamin B-12

While supplements are available, it’s generally preferable to obtain nutrients from natural food sources whenever possible. Vitamin B-12 is primarily found in animal-based products, but some fortified foods can also provide this essential nutrient.

Animal-Based Sources

• Eggs
• Cheese
• Fish (especially salmon, trout, and tuna)
• Shellfish (clams, oysters, and mussels)
• Liver
• Kidney
• Red meat (beef, lamb)

Fortified Foods

For those following plant-based diets or with limited access to animal products, fortified foods can be a valuable source of vitamin B-12. These may include:

• Fortified plant-based milk (soy, almond, oat)
• Fortified breakfast cereals
• Nutritional yeast
• Some meat substitutes

Recommended Daily Intake of Vitamin B-12

The amount of vitamin B-12 you need daily depends on various factors, including age, pregnancy status, and overall health. The National Institutes of Health has established Recommended Dietary Allowances (RDAs) to guide individuals in meeting their nutritional needs.

RDAs for Vitamin B-12

• 2.4 micrograms (mcg) daily for individuals 14 years and older
• 2.6 mcg daily for pregnant women
• 2.8 mcg daily for breastfeeding women

For adults over 50 years of age, it’s recommended to obtain the RDA through B-12 fortified foods or supplements containing 25 to 100 mcg of B-12. This is because the ability to absorb naturally occurring B-12 may decrease with age.

Potential Side Effects of Vitamin B-12 Supplements

While vitamin B-12 is generally considered safe when taken as directed, some individuals may experience side effects, particularly when taking high doses or receiving injectable forms of the supplement. It’s important to note that many of these side effects are rare and often associated with excessive intake or underlying health conditions.

Common Side Effects

• Mild diarrhea
• Itching
• Skin rash
• Headache
• Dizziness
• Nausea
• Vomiting

Rare but Serious Side Effects

• Pulmonary edema
• Congestive heart failure (early in treatment)
• Vein thrombosis
• Sensation of swelling
• Polycythemia vera (a rare, slow-growing blood cancer)

Can vitamin B-12 supplements cause allergic reactions? In very rare cases, individuals may experience severe allergic reactions (anaphylaxis) to vitamin B-12 supplements. Symptoms of anaphylaxis include swelling of the face, tongue, and throat, as well as difficulty swallowing and breathing. If you experience these symptoms after taking a B-12 supplement, seek immediate medical attention.

Interactions with Medications and Other Supplements

Certain medications and supplements can interfere with the absorption or effectiveness of vitamin B-12. If you’re taking any of the following, it’s crucial to consult with your healthcare provider about potential interactions and proper supplementation:

• Colchicine
• Metformin
• Proton pump inhibitors
• Vitamin C
• Chloramphenicol
• H2 blockers
• Aminosalicylic acid
• Folic acid supplements

How can you manage potential interactions? Your healthcare provider may recommend taking vitamin B-12 supplements at different times than other medications or supplements to ensure optimal absorption. For example, you might take B-12 in the morning and other medications in the evening.

Safe Usage of Vitamin B-12 Supplements

To minimize the risk of side effects and ensure you’re getting the appropriate amount of vitamin B-12, follow these guidelines:

1. Consult your healthcare provider before starting any new supplement regimen.
2. Follow the recommended dosage on the supplement label or as prescribed by your doctor.
3. If you’re pregnant or breastfeeding, only take B-12 supplements under medical supervision.
4. Discontinue use and seek medical attention if you experience any adverse effects.
5. Inform your healthcare provider about all medications and supplements you’re taking to avoid potential interactions.

Is it possible to overdose on vitamin B-12? While vitamin B-12 is water-soluble and excess amounts are typically excreted in urine, taking very high doses can lead to side effects. It’s best to stick to the recommended dosage unless otherwise directed by a healthcare professional.

Recognizing and Addressing Vitamin B-12 Deficiency

Vitamin B-12 deficiency can lead to various health issues, including anemia, neurological problems, and cognitive decline. Certain groups are at higher risk of deficiency, including:

• Older adults
• Vegetarians and vegans
• Individuals with gastrointestinal disorders (e.g., Crohn’s disease, celiac disease)
• Those who have undergone weight loss surgery
• People taking certain medications (e.g., metformin, proton pump inhibitors)

What are the symptoms of vitamin B-12 deficiency? Common signs include fatigue, weakness, constipation, loss of appetite, weight loss, and megaloblastic anemia. Neurological symptoms may include numbness and tingling in the hands and feet, balance problems, depression, confusion, and poor memory.

If you suspect a B-12 deficiency, consult your healthcare provider for proper diagnosis and treatment. They may recommend blood tests to check your B-12 levels and determine the most appropriate course of action, which may include dietary changes, oral supplements, or B-12 injections.

Alternative Forms of Vitamin B-12 Supplementation

While oral supplements are the most common form of vitamin B-12 supplementation, there are alternative options available for those who may have difficulty with absorption or prefer different methods:

1. Sublingual Tablets or Lozenges

These dissolvable tablets are placed under the tongue, allowing for direct absorption into the bloodstream through the mucous membranes. This method may be beneficial for individuals with gastrointestinal absorption issues.

2. Nasal Gels

B-12 nasal gels provide another alternative route of administration, bypassing the digestive system. This form may be particularly useful for those with severe malabsorption issues.

3. Intramuscular Injections

For individuals with severe B-12 deficiency or those unable to absorb the vitamin through oral means, intramuscular injections may be prescribed. These are typically administered by a healthcare professional.

4. Transdermal Patches

B-12 patches applied to the skin offer a non-invasive method of supplementation. While less common, they may be an option for those who prefer not to take oral supplements or injections.

Which form of B-12 supplementation is most effective? The best form depends on individual factors such as the severity of deficiency, absorption capabilities, and personal preferences. Consult with your healthcare provider to determine the most appropriate option for your specific needs.

Monitoring Vitamin B-12 Levels and Adjusting Supplementation

Regular monitoring of vitamin B-12 levels is crucial, especially for those at risk of deficiency or those taking supplements. Your healthcare provider may recommend periodic blood tests to assess your B-12 status and adjust supplementation as needed.

Factors That May Necessitate Dosage Adjustments

• Changes in diet (e.g., adopting a plant-based diet)
• Pregnancy or breastfeeding
• Aging
• Development of gastrointestinal disorders
• Changes in medication regimens

How often should B-12 levels be checked? For individuals with no known deficiency or risk factors, B-12 levels may be checked as part of routine health screenings. Those with known deficiencies or risk factors may require more frequent monitoring, typically every 6-12 months or as recommended by their healthcare provider.

If you experience any unusual symptoms or side effects while taking B-12 supplements, don’t hesitate to consult your healthcare provider. They can help determine if your dosage needs adjustment or if there are underlying issues that need to be addressed.

Lifestyle Factors Affecting Vitamin B-12 Absorption and Utilization

Various lifestyle factors can impact your body’s ability to absorb and utilize vitamin B-12 effectively. Understanding these factors can help you optimize your B-12 intake and overall health:

1. Alcohol Consumption

Excessive alcohol intake can interfere with B-12 absorption and storage in the liver. Moderate your alcohol consumption to support optimal B-12 levels.

2. Smoking

Smoking has been associated with lower B-12 levels. Quitting smoking can improve overall health and potentially enhance B-12 absorption.

3. Stress

Chronic stress may affect nutrient absorption and utilization. Implement stress-management techniques such as meditation, yoga, or regular exercise to support overall health and nutrient absorption.

4. Hydration

Adequate hydration is essential for proper nutrient absorption and transportation throughout the body. Aim to drink sufficient water throughout the day.

5. Physical Activity

Regular exercise can improve circulation and overall health, potentially supporting better nutrient absorption and utilization.

How can you optimize your lifestyle for better B-12 absorption? Focus on maintaining a balanced diet rich in B-12 sources, staying hydrated, managing stress, avoiding excessive alcohol consumption, quitting smoking, and engaging in regular physical activity. These lifestyle changes can support not only B-12 absorption but overall health and well-being.

The Future of Vitamin B-12 Research and Supplementation

As our understanding of nutrition and human health continues to evolve, ongoing research into vitamin B-12 and its effects on the body may lead to new discoveries and improved supplementation methods. Some areas of current and future research include:

1. Personalized Nutrition

Advancements in genetic testing and personalized medicine may lead to more tailored B-12 supplementation recommendations based on individual genetic profiles and health status.

2. Novel Delivery Methods

Researchers are exploring innovative ways to deliver B-12, such as nano-encapsulation technology, which could enhance absorption and reduce the need for frequent dosing.

3. B-12 and Cognitive Health

Further studies are investigating the potential role of B-12 in cognitive function and its possible protective effects against neurodegenerative diseases.

4. Interaction with Gut Microbiome

Emerging research is exploring the relationship between gut bacteria and B-12 absorption, which could lead to new strategies for optimizing B-12 status through probiotic interventions.

5. Plant-Based B-12 Sources

Scientists are investigating potential plant-based sources of B-12, which could benefit vegetarians and vegans who currently rely on fortified foods or supplements.

What potential breakthroughs can we expect in B-12 supplementation? While it’s difficult to predict specific outcomes, ongoing research may lead to more efficient and personalized B-12 supplementation strategies, improved understanding of B-12’s role in various health conditions, and potentially new natural sources of this essential vitamin.

As research progresses, it’s important to stay informed about the latest developments in vitamin B-12 supplementation and nutrition. Consult with healthcare professionals and reputable sources to ensure you’re making informed decisions about your B-12 intake and overall health.

Vitamin B-12 Side Effects

Vitamin B-12 Side Effects

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Medically reviewed by Jared Meacham, Ph. D., RD, PMP, MBA, CSCS — By Emily Cronkleton — Updated on June 8, 2023

Your doctor will give you the right dosage of vitamin B-12 supplement, especially if you will inject it. Taking too much can cause side effects like nausea, headache, dizziness, and in rarely, blood clots or cancer.

Everyone needs vitamin B-12, and most people get enough through their diet. However, it’s important to know what side effects occur when you take too much.

Vitamin B-12 is water-soluble and absorbed in the intestines. After it’s absorbed, it’s used to make DNA and red blood cells. Vitamin B-12 that isn’t being used is stored in the liver. But if you take supplements, you might ingest more than your body needs.

Oral vitamin B-12 is safe to take at recommended doses for healthy people.

Injectable vitamin B-12, which is used to treat significant deficiencies, can cause the following side effects:

• mild diarrhea
• itching
• skin rash
• headache
• dizziness
• nausea
• vomiting
• pulmonary edema and congestive heart failure early in treatment
• vein thrombosis
• sensation of swelling
• polycythemia vera (rare, slow growing blood cancer)

Vitamin B-12 can cause very rare but serious allergic reactions (anaphylaxis). This includes swelling of the face, tongue, and throat, and difficulty swallowing and breathing. If this occurs after you take vitamin B-12, call 911 or your local emergency services immediately.

Some agents are linked to reduced absorption or serum levels of vitamin B-12. You may need vitamin B-12 supplements if you take any of the following:

• colchicine
• metformin
• proton pump inhibitors
• vitamin C
• chloramphenicol
• h3 blockers
• aminosalicylic acid

Folic acid supplements may interfere with vitamin B-12. Be sure to tell your doctor if you take folic acid.

You may need to take vitamin B-12 separately from the above drugs and supplements — say, one in the morning and one at night — so you can get the full dose of vitamin B-12.

Don’t take vitamin B-12 supplements if you have sensitivities or allergies to vitamin B-12, cobalt, and any other ingredients. Vitamin B-12 is safe to take in recommended dosages if you’re pregnant or breastfeeding.

If you notice any adverse effects after you start taking vitamin B-12 supplements, you should discontinue use immediately. Seek medical attention if your symptoms get worse or are severe.

You can consult your doctor to establish an appropriate dose if it’s determined that you don’t get enough B-12 from food sources.

According to the National Institutes of Health, the recommended dietary amounts (RDAs) are as follows:

• 2.4 micrograms (mcg) daily for ages 14 years or older
• 2.6 mcg daily for pregnant women
• 2.8 mcg daily for breastfeeding women

If you’re over the age of 50, you should try to get your RDA by eating foods with B-12 or by taking a supplement containing 25 to 100 mcg of B-12.

Foods with vitamin B-12 include:

• eggs
• cheese
• fish
• shellfish
• liver
• kidney
• red meat

See your doctor if you have bothersome side effects that don’t go away once you stop taking the supplements. Avoid taking supplements if possible, and try to get B-12 from food sources.

If you develop any side effects from taking vitamin B-12, you can stop taking the supplement and the symptoms should subside.

After this, you’ll need to determine either an appropriate dose or how to get the vitamin B-12 you need from food sources. You can discuss this with your doctor.

Article resources

• Cyanocobalamin – cyanocobalamin injection. (2023). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a66eb3c4-3e1d-4d49-b963-4fa2334cc9b6
• Vitamin B12: Fact sheet for health professionals. (2022). https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/

Last medically reviewed on June 8, 2023

How we reviewed this article:

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Jun 8, 2023

Written By

Emily Cronkleton

Edited By

John Bassham

Medically Reviewed By

Jared Meacham, Ph. D., RD, PMP, MBA, CSCS

Copy Edited By

Copy Editors

Feb 15, 2023

Written By

Emily Cronkleton

Edited By

Frank Crooks

VIEW ALL HISTORY

Share this article

Medically reviewed by Jared Meacham, Ph.D., RD, PMP, MBA, CSCS — By Emily Cronkleton — Updated on June 8, 2023

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Vitamin B-12 Side Effects

Vitamin B-12 Side Effects

• Health Conditions
  • Featured
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    • IBD
    • Migraine
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    • Depression
    • Fibromyalgia
    • Heart Disease
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    • No More Silence
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• Plan
  • Health Challenges
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    • Sugar Savvy
    • Move Your Body
    • Gut Health
    • Mood Foods
    • Align Your Spine
  • Find Care
    • Primary Care
    • Mental Health
    • OB-GYN
    • Dermatologists
    • Neurologists
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    • Am I Depressed? A Quiz for Teens
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    • Find Healthy Snacks
    • Drugs A-Z
    • Health A-Z
• Connect
  • • Breast Cancer
    • Inflammatory Bowel Disease
    • Psoriatic Arthritis
    • Migraine
    • Multiple Sclerosis
    • Psoriasis

Medically reviewed by Jared Meacham, Ph. D., RD, PMP, MBA, CSCS — By Emily Cronkleton — Updated on June 8, 2023

Your doctor will give you the right dosage of vitamin B-12 supplement, especially if you will inject it. Taking too much can cause side effects like nausea, headache, dizziness, and in rarely, blood clots or cancer.

Everyone needs vitamin B-12, and most people get enough through their diet. However, it’s important to know what side effects occur when you take too much.

Vitamin B-12 is water-soluble and absorbed in the intestines. After it’s absorbed, it’s used to make DNA and red blood cells. Vitamin B-12 that isn’t being used is stored in the liver. But if you take supplements, you might ingest more than your body needs.

Oral vitamin B-12 is safe to take at recommended doses for healthy people.

Injectable vitamin B-12, which is used to treat significant deficiencies, can cause the following side effects:

• mild diarrhea
• itching
• skin rash
• headache
• dizziness
• nausea
• vomiting
• pulmonary edema and congestive heart failure early in treatment
• vein thrombosis
• sensation of swelling
• polycythemia vera (rare, slow growing blood cancer)

Vitamin B-12 can cause very rare but serious allergic reactions (anaphylaxis). This includes swelling of the face, tongue, and throat, and difficulty swallowing and breathing. If this occurs after you take vitamin B-12, call 911 or your local emergency services immediately.

Some agents are linked to reduced absorption or serum levels of vitamin B-12. You may need vitamin B-12 supplements if you take any of the following:

• colchicine
• metformin
• proton pump inhibitors
• vitamin C
• chloramphenicol
• h3 blockers
• aminosalicylic acid

Folic acid supplements may interfere with vitamin B-12. Be sure to tell your doctor if you take folic acid.

You may need to take vitamin B-12 separately from the above drugs and supplements — say, one in the morning and one at night — so you can get the full dose of vitamin B-12.

Don’t take vitamin B-12 supplements if you have sensitivities or allergies to vitamin B-12, cobalt, and any other ingredients. Vitamin B-12 is safe to take in recommended dosages if you’re pregnant or breastfeeding.

If you notice any adverse effects after you start taking vitamin B-12 supplements, you should discontinue use immediately. Seek medical attention if your symptoms get worse or are severe.

You can consult your doctor to establish an appropriate dose if it’s determined that you don’t get enough B-12 from food sources.

According to the National Institutes of Health, the recommended dietary amounts (RDAs) are as follows:

• 2.4 micrograms (mcg) daily for ages 14 years or older
• 2.6 mcg daily for pregnant women
• 2.8 mcg daily for breastfeeding women

If you’re over the age of 50, you should try to get your RDA by eating foods with B-12 or by taking a supplement containing 25 to 100 mcg of B-12.

Foods with vitamin B-12 include:

• eggs
• cheese
• fish
• shellfish
• liver
• kidney
• red meat

See your doctor if you have bothersome side effects that don’t go away once you stop taking the supplements. Avoid taking supplements if possible, and try to get B-12 from food sources.

If you develop any side effects from taking vitamin B-12, you can stop taking the supplement and the symptoms should subside.

After this, you’ll need to determine either an appropriate dose or how to get the vitamin B-12 you need from food sources. You can discuss this with your doctor.

Article resources

• Cyanocobalamin – cyanocobalamin injection. (2023). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a66eb3c4-3e1d-4d49-b963-4fa2334cc9b6
• Vitamin B12: Fact sheet for health professionals. (2022). https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/

Last medically reviewed on June 8, 2023

How we reviewed this article:

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Jun 8, 2023

Written By

Emily Cronkleton

Edited By

John Bassham

Medically Reviewed By

Jared Meacham, Ph. D., RD, PMP, MBA, CSCS

Copy Edited By

Copy Editors

Feb 15, 2023

Written By

Emily Cronkleton

Edited By

Frank Crooks

VIEW ALL HISTORY

Share this article

Medically reviewed by Jared Meacham, Ph.D., RD, PMP, MBA, CSCS — By Emily Cronkleton — Updated on June 8, 2023

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• Vitamin B12 Deficiency and Weight Gain — What to Know

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• What Is a Vitamin B-12 Test?

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  READ MORE

• Vitamin B12 (folate deficiency anemia) Signs and Symptoms

  By Jillian Kubala, MS, RD

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  READ MORE

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  By Ansley Hill, RD, LD

  Pueraria mirifica — or Kwao Krua — has long been used as a rejuvenation therapy in traditional Thai medicine practices. Here are 7 emerging health…

  READ MORE

Cyanocobalamin (Vitamin B12) – instructions for use, doses, side effects, reviews of the drug:

Description of the drug in 1998

Date of approval: 07/31/1998

Content

• Active substance
• ATX
• Pharmacological group
• Nosological classification (ICD-10)
• Composition and form of release
• pharmachologic effect
• pharmachologic effect
• Indications
• Contraindications
• Dosage and administration
• Side effects
• Interaction
• Precautionary measures
• Storage conditions
• Best before date
• Reviews

Active ingredient

Cyanocobalamin* (Cyanocobalamin*)

ATX

B03BA01 Cyanocobalamin

Pharmacological group

Stimulants of hematopoiesis

Vitamins and vitamin-like products

Nosological classification (ICD-10)

ICD-10 code list

Composition and formulation

1 ml solution for injection contains cyanocobalamin (vitamin B ₁₂ ) 200 or 500 mcg; in ampoules of 1 ml, in a cardboard box 10 pcs.

Pharmacological action

Pharmacological action –

hematopoietic , stimulating cell metabolism .

Participates in the transfer of methyl fragments, the formation of choline, methionine, creatine, nucleic acids, the maturation of erythrocytes, promotes the accumulation of compounds containing sulfhydryl groups in erythrocytes.

Participates in the transfer of methyl fragments, the formation of choline, methionine, creatine, nucleic acids, the maturation of erythrocytes, promotes the accumulation of compounds containing sulfhydryl groups in erythrocytes.

Indications

Anemia (Addison-Birmer, alimentary macrocytic, iron deficiency,
posthemorrhagic, aplastic, caused by toxic substances and drugs), cirrhosis of the liver,
hepatitis, myelosis, polyneuritis, sciatica, trigeminal neuralgia, amyotrophic lateral sclerosis, children
cerebral palsy, multiple sclerosis, Down’s disease, skin diseases, peripheral nerve injuries.

Contraindications

Thromboembolism, angina.

Dosage and administration

Information for healthcare professionals only.
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S/C, IM, IV and intralumbar.

Addison-Birmer anemia – 100-200 mcg every other day; with Addison-Birmer anemia with symptoms of funicular myelosis and with macrocytic anemia with disorders of the nervous system – 500 mcg or more per injection (daily for the first week, and then with intervals between injections of up to 5-7 days). Simultaneously appoint folic acid. In the period of remission, in the absence of funicular myelosis phenomena, 100 mcg is administered for maintenance therapy 2 times a month, and in the presence of neurological phenomena, 200-400 mcg 2-4 times a month.

For iron deficiency and posthemorrhagic anemia – 30-100 mcg 2-3 times a week; with aplastic anemia (especially in children) – 100 mcg until the onset of clinical and hematological improvement; with alimentary anemia in children at an early age and in premature babies – 30 mcg / day for 15 days.

In diseases of the central nervous system and neurological diseases with pain syndrome, it is administered in increasing doses from 200 to 500 mcg per injection, and when the condition improves, 100 mcg/day; course – up to 2 weeks.

In traumatic lesions of the peripheral nerves – 200-400 mcg every other day for 40-45 days.

For hepatitis and liver cirrhosis, 30–60 mcg per day or 100 mcg every other day for 25–40 days.

With dystrophies in young children, Down’s disease and cerebral palsy – 15-30 mcg every other day.

In case of funicular myelosis, amyotrophic lateral sclerosis, multiple sclerosis, sometimes 15-30 mcg is injected into the spinal canal (gradually increasing the dose to 200-250 mcg).

Side effects

Excitation, pain in the heart, tachycardia, allergic reactions.

Interactions

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Incompatible (in one syringe) with thiamine bromide, riboflavin.

Precautions

In angina pectoris, use with caution and in lower doses.

Storage conditions

In a place protected from light.

Keep out of reach of children.

Expiry date

2 years.

Do not use after the expiry date which is stated on the packaging.

Update date: 04/30/2020

Vitamin B12 – instructions for use, doses, side effects, reviews of the drug: instant tablets, 5000 mcg

0.004 ‰

Analogs

Description selection

instant tablets

5000 mcg

injection

0.2 mg/ml

All forms of release, dosages, registration certificates, drug manufacturers, drug characteristics

Product description Vitamin B12 (solution for injection, 0.2 mg/ml) based on the official instructions, approved by the manufacturer in 1998

Date approved: 07/31/1998

Contents

• Active substance
• ATX
• Pharmacological group
• Composition and form of release
• Dosage and administration
• Storage conditions
• Best before date
• Reviews

Active ingredient

Cyanocobalamin* (Cyanocobalamin*)

ATX

B03BA01 Cyanocobalamin

Pharmacological group

Stimulants of hematopoiesis

Vitamins and vitamin-like products

Composition and form of release

1 ampoule with 1 ml solution for injection contains cyanocobalamin 200 or 500 mcg; in a box of 10 pcs. , complete with ampoule knife.

Dosage and administration

Information for healthcare professionals only.
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S/C, IM, IV and intralumbar. For Addison-Birmer anemia (in combination with folic acid)
– 100-200 mcg once a day, for 2 days; with Addison-Birmer anemia with symptoms
funicular myelosis and macrocytic anemia with disorders of the nervous system – 500 mcg and
more per injection (in the first week daily, and then at intervals between injections up to 5-7 days). During
remissions – 100 mcg 2 times a month (maintenance therapy), in the presence of neurological phenomena
(funicular myelosis) – 200-400 mcg 2-4 times a month. With iron deficiency and
posthemorrhagic anemia – 30-100 mcg 2-3 times a week; with aplastic anemia
(especially in children) – 100 mcg until the onset of clinical and hematological improvement; with alimentary
anemia in children at an early age and in premature babies – 30 mcg / day for 15 days.