In cases of iron and vitamin B12 deficiency, normalization of MCH (mean corpuscular hemoglobin) levels typically occurs after B12 and Ferritin levels have stabilized. A study involving 60 patients with B12 deficiency indicated that hematologic parameters, including MCH, showed significant improvement over a 90-day period. Early signs of treatment effectiveness, such as reticulocytosis, can be observed within 5 to 10 days of initiating therapy. The study also highlighted that both oral and intramuscular B12 treatments were effective, with no significant differences noted between the two methods. However, in cases of pernicious anemia, where gastric intrinsic factor is deficient, oral treatment may still be effective with specific B12 preparations or higher doses.
