, Volume 79, Issue 12, pp 1592-1596
Date: 14 Mar 2012

Addition of Cobalamin to Iron and Folic Acid Improves Hemoglobin Rise in Nutritional Anemia

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To assess whether addition of cobalamin (cbl) to iron-folic acid will result in improved response in nutritional anemia.


This study included 150 children aged between 0.5–5 y having nutritional anemia. Anemia was categorized for severity and red cell morphology. Serum levels of ferritin were obtained in all cases while levels of cbl and folic acid (FA) were done only in children having macrocytic or dimorphic anemia. Children were randomized to receive either iron and FA (Group I) or iron, FA and cbl (Group II). Response to treatment was assessed at 2, 4 and 8 wk.


Of all the 150 patients, iron deficiency was documented in 111 patients. Of the 41 cases in whom, Cbl and FA levels were done, 97.56% and 53.66% had deficiency of cbl and FA respectively. Patients in group II had higher Hb level at 2, 4 and 8 wk (significant at 4 and 8 wk). Percentage Hb rise from baseline Hb was significantly higher in group II (p 0.00). In group II, increase in Hb among cases with macrocytosis and others were similar although percentage increase in Hb was more pronounced among patients with macrocytic anemia or dimorphic anemia. However, this difference was statistically not significant (p = 0.18).


Children receiving cbl in addition to iron and FA showed an improved hematological response.