B-12 deficiency is a common side effect in patients suffering from Crohn's disease, a type of inflammatory bowel disease. The recommended treatment is monthly B-12 injections, which can be given by a medical professional or self-administered by the patient. Patients who don't look forward to a monthly needle stick often wonder if oral B-12 would provide the nutrition their bodies need to stave off anemia and peripheral neuropathy.
Crohn's Disease and B-12 Absorption
Vitamin B-12 is an important component in red blood cell production and nerve health. B-12 deficiency can lead to anemia and nerve damage. Vitamin B-12 is absorbed in a part of the small intestine called the ileum. Since the ileum is a common site for Crohn's disease and partial ileum removal is a common surgery performed on Crohn's patients, this population is typically unable to absorb enough B-12 from their diets. The preferred method of B-12 supplementation is by injection, but other methods are available.
Oral B-12
Vitamin B-12 is a common component of multivitamins. When B-12 deficiency is not caused by an absorption issue, it can be remedied by taking B-12 pills. Patients with Crohn's disease are less able to absorb B-12 in their intestines and have the same problem with getting the vitamin from pills as they do with food. Some Crohn's patients have outbreaks in parts of their intestines other than the ileum, so oral B-12 can help. Even patients who have active Crohn's in the ileum or who have had some of the ileum removed may still be able to absorb at least some B-12 from food and pills.
Sublingual B-12
Another type of vitamin B-12 pill is one which dissolves under the tongue rather than being swallowed. The B-12 is absorbed directly into the blood stream, bypassing the gastrointestinal system and any absorption problems. In a 2003 study published in the "British Journal of Clinical Pharmacology," sublingual B-12 was not found to be any more effective than pills, but the study does not say whether the subjects had absorption problems.
Nasal B-12
Another option for patients who don't want to give themselves B-12 injections is to use a nasal form of cyanocobalamin, the manmade form of B-12. The medication is available as a nasal spray or a nasal gel. Like the sublingual tablets, B-12 is absorbed directly into the bloodstream and shouldn't be affected by B-12 absorption problems in the intestines. As with sublingual B-12, no studies have looked at the absorption effects of nasal B-12 on patients with Crohn's disease.
References
- Centers for Disease Control: Learn More about Vitamin B-12 Deficiency
- Crohn's & Colitis Foundation of America; IBD and Your Immune System; Michael Margolin, M.D., FACP, FACG; 2009
- "British Journal of Clinical Pharmacology"; Replacement Therapy for Vitamin B-12 Deficiency: Comparison Between the Sublingual and Oral Route; Amir Sharabi, et al.; December 2003
- Drugs.com: Cyanocobalamin
