What is the appropriate treatment for vitamin B12 deficiency?

Vitamin B12 deficiency is primarily treated with vitamin B12 supplementation. This deficiency can result from inadequate dietary intake, malabsorption syndromes, or conditions affecting intrinsic factor production, such as pernicious anemia. Supplementing vitamin B12 effectively replenishes the body's stores and resolves associated symptoms, such as macrocytic anemia and neurological manifestations, which can occur if the deficiency is left untreated.

Folic acid supplementation does not treat vitamin B12 deficiency and can actually mask some hematological symptoms, leading to potential neurological complications if the underlying B12 deficiency is not addressed. Dietary changes may help in increasing vitamin B12 levels, especially if the deficiency is due to insufficient intake; however, they are typically not sufficient alone for those with significant deficiencies or malabsorption issues. Iron supplementation would not be effective for a vitamin B12 deficiency and might even complicate the clinical picture, as the primary issue is not iron deficiency but rather a lack of vitamin B12.

For these reasons, the most appropriate and effective treatment for vitamin B12 deficiency is direct supplementation with vitamin B12.