One great pleasure of hematologic practice is the predictable response to specific therapy of a patient with deficiency anemia. The deficiency anemias, caused by lack of cobalamin, folic acid, or iron, are curable with an optimal response to small doses of the missing nutrient and minimal risk of side effects. Not only that, but before the anemia is corrected the patient begins to feel better. With such information in the public domain, why is overtreatment of deficiency anemia the standard practice?
Pernicious anemia (PA) and other cobalamin deficiencies are always treated with large, frequent intramuscular injections of cyanocobalamin: 1,000 μg per injection until ten or 20 injections have been given and, after that, one a month.1 When Minot and Murphy2 described their method of treating PA by feeding 240 g of liver per day, they achieved remissions in all patients. Such daily doses of liver contain
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 5
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.