[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Views 2,002
Citations 0
Research Letter
July 15, 2019

Prevalence of Inappropriateness of Parenteral Vitamin B12 Administration in Ontario, Canada

Author Affiliations
  • 1Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 2Division of Medical Oncology & Hematology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • 3Department of Laboratory Medicine & Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • 4Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
  • 5ICES, Toronto, Ontario, Canada
JAMA Intern Med. 2019;179(10):1434-1436. doi:10.1001/jamainternmed.2019.1859

Randomized clinical trials demonstrate that treating vitamin B12 (cobalamin, or hereinafter B12) deficiency with oral supplementation substantially increases serum B12 levels compared with intramuscular injections, with no difference in hematologic or neuropsychiatric outcomes.1 Despite this, some primary care physicians still inappropriately administer B12 injections to elderly patients.2 To our knowledge, there is no published literature characterizing prescribing patterns of intramuscular B12 using laboratory data to document patient serum levels. In this study, we assessed the prevalence of inappropriate B12 supplementation using population-based databases and estimated the associated cost.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words