Another interesting article, this one with a focus on assessment of issues pertaining to B12 deficiency. Amazingly, when contrasting things known in this article to current medical practices, the article was printed in 2005.
Note the following regarding treatment administered as part of the study:
"Patients with suspected deficiency were treated with cyanocobalamin 2 mg per day orally or 1 mg intramuscularly 3 times a week for 2 weeks, weekly for 8 weeks, and monthly thereafter. All patients were reevaluated within 3 months of beginning Cbl therapy."
This, B12 deficiency patients with neurological symptoms should be considered as under-treated, given that they received considerably less B12 than the recommended injection every other day or twice per week.
Study requirements for being considered to be a responder to (under-) treatment seems to be quite a high bar, especially considering that subjects could have been experiencing progressive damage for many years:
"Neurologic improvement in these patients during Cbl therapy was considered to be significant if paresthesias completely resolved, observed ataxic gait became normal, and/or vibratory sensation that was completely absent at least in the ankles prior to therapy became easily detectable within 6 months of treatment."
- and about to change again in November, when the new NICE guidelines are published.
Keep your fingers crossed that this latest will contain a much more realistic treatment regime.
WiscGuy : "all patients were reevaluated within three months"..... at two and a half months, they would have had only 14 cyanocobalamin injections. A big ask to get your paraesthesia sorted in this timeframe !
It took me three months of 2 injections a week before I even felt anything when being injected - almost certain up to that moment, given my paranoia and the nurses' reluctance, that the injections weren't even being administered !
Improvements in health were visible, so this frequency was continued by a delighted GP for another three months. Then I started to go downhill again - and was sent to consultants at this point, considered "beyond the remit of primary care".
So let's hope those research patients were monitored long after their initial reevaluation.
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