Though rare, medication can be cause of ED
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DEAR DR. ROACH: My wife and I had a discussion about pernicious anemia. I've had it for over six years. Is there a cure? -- B.M.
ANSWER: There is not a cure for pernicious anemia, which is caused by an autoimmune destruction of the stomach cells that secrete a protein called "intrinsic factor," which is required for vitamin B-12 to be absorbed efficiently. Without vitamin B-12, anemia is common, but people also may develop neurologic defects, especially numbness, and sometimes psychiatric changes as well.
Fortunately, there is very effective and easy treatment. B-12 can be given by monthly injection, eliminating the need for intrinsic factor. Even easier is giving massive oral doses of vitamin B-12: An oral dose of 1 milligram is 1,000 times more than what is normally needed (1 microgram), and allows enough B-12 to be absorbed. Both injection and oral B-12 are good treatments. I recommend oral treatment, but many of my patients are so used to getting a monthly B-12 shot that they continue to do so, even though a pill a day is cheap and effective.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.
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