End of week two. General findings: improved state of muscular contraction and marked decrease in paresthesias. Better sleep. Etc. (Will post tomorrow on week two findings).
As a result, conducted further reading and decided that I will continue this course of treatment at 2000mcg daily for 90 days (based on 2011 evidence that supports this - see below). Then I will reassess. Then, if required, proceed to 120 days at same level.
The following information is from Am Fam Physician. 2011 Jun 15;83(12):1425-1430.
Link:
http://www.aafp.org/afp/2011/0615/p1425.html
Quote:
Treatment
Treatment of clinical vitamin B12 deficiency has traditionally been accomplished by intramuscular injection of crystalline vitamin B12 at a dosage of 1 mg weekly for eight weeks, followed by 1 mg monthly for life.1,2 In a 2005 Cochrane review, patients who received high dosages of oral vitamin B12 (1 to 2 mg daily = 1000 - 2000 mcg) for 90 to 120 days had an improvement in serum vitamin B12 similar to patients who received intramuscular injections of vitamin B12.20 These results were consistent in patients regardless of the etiology of their vitamin B12 deficiency, including malabsorption states and pernicious anemia. Given the lower cost and ease of administration of oral vitamin B12, this might be a reasonable choice for replacement in many patients. In cases of megaloblastic anemia, reticulocytosis generally occurs within a few days, and the hematocrit generally normalizes over several weeks. Advanced neurologic symptoms may not respond to replacement. Vitamin B12 has been demonstrated to be safe in doses up to 1,000 times the recommended dietary allowance and is safe in pregnancy.
|