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61 In practice, some patients may be able to switch to very high dose (ie, 2000 mcg daily) oral supplementation instead of continuing parenteral administration, but it is impossible to predict in whom this can be done safely, and many are at risk of worsening symptoms which may become permanent

In blood plasma, it binds to proteins by 50-80%, is metabolized in the liver, and excreted after 4-5 hours by the kidneys, mainly in the form of metabolites

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Laboratory evidence of parietal cell antibodies is approximately 85 to 90 percent sensitive for the diagnosis of pernicious anemia