Comparison of Parenteral and Oral Vitamin B12 in Children with Nutritional Macrocytic Anemia
DOI:
https://doi.org/10.54112/bcsrj.v7i5.2288Keywords:
Vitamin B12 deficiency, nutritional macrocytic anemia, oral vitamin B12, parenteral vitamin B12, pediatric anemia, randomized controlled trialAbstract
Nutritional vitamin B12 deficiency is an important cause of macrocytic anemia in children. Although parenteral vitamin B12 has traditionally been used for treatment, oral supplementation may provide a simpler and effective alternative. Objective: To compare the efficacy of parenteral and oral vitamin B12 supplementation in children with nutritional macrocytic anemia. Methods: This was a randomized controlled trial conducted at the Department of Pediatric Medicine, Benazir Bhutto Hospital Rawalpindi, from 5th October 2025 till 04th April 2026, including 286 children diagnosed with nutritional macrocytic anemia. Results: Baseline characteristics were comparable between groups. At four weeks, mean hemoglobin improved to 11.3 ± 1.0 g/dL in the oral group compared to 10.9 ± 1.1 g/dL in the parenteral group (p=0.008), while MCV improved to 94.9 ± 4.8 fL versus 96.8 ± 5.2 fL (p=0.014). Resolution of pallor (81.8% vs 70.6%), fatigue (78.3% vs 67.1%), and irritability (74.1% vs 62.9%) was greater with oral therapy. Overall efficacy was significantly higher in the oral group (80.4%) compared to the parenteral group (65.7%) (p=0.006). Serum vitamin B12 levels increased in both groups, with no significant difference (402.7 ± 71.5 vs 388.4 ± 76.3 pg/mL; p=0.097). Conclusion: Oral vitamin B12 supplementation was more effective than parenteral therapy in improving hematological and clinical outcomes in children with nutritional macrocytic anemia and may be considered a practical alternative treatment strategy.
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Copyright (c) 2026 Hajra Afzal, Asad Shabbir, Amber Khalid, Rabia Munir Awan, Mudassir Sharif, Ali Hassan Shah
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