Patients with pernicious anemia should be informed that they will require monthly injections of vitamin B₁₂ for the remainder of their lives. Failure to do so will result in return of the anemia and in development of incapacitating and irreversible damage to the nerves of the spinal cord. Also, patients should be warned about the danger of taking folic acid in place of vitamin B₁₂, because the former may prevent anemia but allow progression of subacute combined degeneration.

A vegetarian diet which contains no animal products (including milk products or eggs) does not supply any vitamin B₁₂. Patients following such a diet, should be advised to take oral vitamin B₁₂ regularly. The need for vitamin B₁₂ is increased by pregnancy and lactation. Deficiency has been recognized in infants of vegetarian mothers who were breast fed, even though the mothers had no symptoms of deficiency at the time.

Last reviewed on RxList: 10/23/2008
This monograph has been modified to include the generic and brand name in many instances.