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Most research protocols specify fasted administration with a 30–60 minute wait before eating

Cellular Research

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Therapeutic management The classic treatment of cobalamin deficiency, particularly when the cause is not dietary deficiency, has been parenteral administration — usually by intramuscular injection — of the vitamin (in the form of cyanocobalamin and, more rarely, hydroxocobalamin).1 , 17 , 18 , 32 In France, the recommended practice to build up the tissue stores of the vitamin quickly and correct serum cobalamin hypovitaminosis, particularly in the case of pernicious anemia, involves administration of 1000 μg of cobalamin per day for 1 week, followed by 1000 μg per week for 1 month and then by 1 injection of the same dose once per month, normally for the rest of the patient's life (Table 3).32 , 33 In other Western countries, dosages of 100–1000 μg per day are used.17 In cases other than those caused by nutritional deficiency, alternative routes of administration have recently been proposed: oral17 , 18 , 39 , 40 , 41 , 42 or nasal.43 , 44 Our working group has developed an effective oral treatment of food-cobalamin malabsorption40 , 41 and pernicious anemia45 using crystalline cobalamin (cyanocobalamin)

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