Therapeutic target
Normalization of symptoms by restoring physiologic conditions.
Therapy recommendations
- Therapy recommendations depending on the type of deficiency: folic acid and/or vitamin B12 deficiency.
- See also under “Further therapy“.
Substitution therapy with cobalamin (vitamin B12)
The diagnosis of megaloblastic anemia due to vitamin B12 deficiency should always be followed by substitution therapy with cobalamin in addition to causal (cause) therapy. Cobalamin is usually administered intravenously (“into the vein“) or intramuscularly (“into the muscle”) to ensure rapid and adequate therapy. One starts with an initial dose of 1,000 µg of cobalamin per week for eight weeks and then continues therapy with cyanocobalamin intramuscularly once a month for life.
Substitution therapy with folic acid
If folic acid deficiency is diagnosed, substitution therapy should also be given in addition to causal therapy. This involves taking 1-5 mg of folic acid orally (“by mouth,” e.g., as a tablet) daily. Depending on the exact cause of the disease, lifelong substitution may be required. In women, preconceptional (“before conception“) administration of folic acid is recommended to protect against neural tube defects (e.g., spina bifida/open back), that is, intake one month before pregnancy.
