Health Care Maintenance

<100

• - diet
• - exercise
• - statins
• - controlling coexisting diabetes

>500μg

Studies have shown that oral vitamin B12 at daily doses of 1000μg is effective for treatment of vitamin B12 deficiency even in the absence of intrinsic factor, an acidic environment, or terminal ileum resection.  There is strong evidence of an alternative pathway to the the usual intrinsic factor/terminal ileum pathway but doses of 500μg or less are only variably absorbed via this pathway so need higher doses.

• yellow fever
• MMR
• smallpox
• varicella

Avoid in immunocompromised & pregnant pts.

• influenza
• cholera
• plague
• polio
• hep A
• rabies

• tetanus
• diphtheria

• Pneumococcal
• Hemophilus influenzae B