Q:

A 56 year old woman is known case of pernicious anemia. She refuses to take hydroxycobalamin IM as she is needle shy. She asks for oral medication. Why will oral meds be not effective?

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A 56 year old woman is known case of pernicious anemia. She refuses to take hydroxycobalamin IM as she is needle shy. She asks for oral medication. Why will oral meds be not effective?


  1. Intrinsic factor deficiency
  2. Malabsorption
  3. Irritated gastric mucosa
  4. Lack of gastric acidity

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The key is A. Intrinsic factor deficiency. [Vitamin B12 cannot be absorbed without intrinsic factor].

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