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RALPH ZALUSKY, M.D.; VICTOR HERBERT, M.D.; WILLIAM B. CASTLE, M.D.

Arch Intern Med. 1962;109(5):545-554.

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Introduction

It is currently well established that supraphysiologic doses of folic acid may reverse the hematologic abnormality in patients who are deficient in vitamin B₁₂.^1-4 On the other hand, the effect of large doses of cyanocobalamin in folic acid-deficient patients has not been clearly determined. Although responses to cyanocobalamin therapy have occasionally been observed in megaloblastic anemia associated with infancy,^5A,^5B pregnancy^6A and the puerperium,^6A,6B cirrhosis of the liver,^7,8 intestinal malabsorption,⁹ and the ingestion of anticonvulsant drugs,¹⁰ they have often been suboptimal or inadequate, whereas folic acid therapy induces prompt remission. Interpretation of these results have been complicated by a number of factors, including: (1) lack of reliable laboratory measures of deficiency of vitamin B₁₂ and folic acid, (2) difficulty in control of dietary folic acid intake, especially in the light of recent evidence indicating the therapeutic efficacy of 25µg. and 50µg. . . . [Full Text PDF of this Article]

Author Affiliations
BOSTON

Postdoctoral Research Fellow, National Heart Institute, National Institutes of Health (Dr. Zalusky).; From the Thorndike Memorial Laboratory and Second and Fourth (Harvard) Medical Services, Boston City Hospital, and the Department of Medicine, Harvard Medical School.

Footnotes
Submitted for publication June 22, 1961.

This investigation was supported in part by Grant A-795 (C5) from the National Institutes of Health, Bethesda, Md., and in part by grants from the National Vitamin Foundation and from Eli Lilly & Co.

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