Antioxidants for female subfertility.

Abstract:

BACKGROUND:A couple may be considered to have fertility problems if they have been trying to conceive for over a year with no success. This may affect up to a quarter of all couples planning a child. It is estimated that for 40% to 50% of couples, subfertility may result from factors affecting women. Antioxidants are thought to reduce the oxidative stress brought on by these conditions. Currently, limited evidence suggests that antioxidants improve fertility, and trials have explored this area with varied results. This review assesses the evidence for the effectiveness of different antioxidants in female subfertility. OBJECTIVES:To determine whether supplementary oral antioxidants compared with placebo, no treatment/standard treatment or another antioxidant improve fertility outcomes for subfertile women. SEARCH METHODS:We searched the following databases (from their inception to September 2016) with no language or date restriction: Cochrane Gynaecology and Fertility Group (CGFG) specialised register, the Cochrane Central Register of Studies (CENTRAL CRSO), MEDLINE, Embase, PsycINFO, CINAHL and AMED. We checked reference lists of appropriate studies and searched for ongoing trials in the clinical trials registers. SELECTION CRITERIA:We included randomised controlled trials (RCTs) that compared any type, dose or combination of oral antioxidant supplement with placebo, no treatment or treatment with another antioxidant, among women attending a reproductive clinic. We excluded trials comparing antioxidants with fertility drugs alone and trials that only included fertile women attending a fertility clinic because of male partner infertility. DATA COLLECTION AND ANALYSIS:Two review authors independently selected eligible studies, extracted the data and assessed the risk of bias of the included studies. The primary review outcome was live birth; secondary outcomes included clinical pregnancy rates and adverse events. We pooled studies using a fixed-effect model, and calculated odds ratios (ORs) with 95% confidence intervals (CIs) for the dichotomous outcomes of live birth, clinical pregnancy and adverse events. We assessed the overall quality of the evidence by applying GRADE criteria. MAIN RESULTS:We included 50 trials involving 6510 women. Investigators compared oral antioxidants, including combinations of antioxidants, N-acetyl-cysteine, melatonin, L-arginine, myo-inositol, D-chiro-inositol, carnitine, selenium, vitamin E, vitamin B complex, vitamin C, vitamin D+calcium, CoQ10, pentoxifylline and omega-3-polyunsaturated fatty acids versus placebo, no treatment/standard treatment or another antioxidant.Very low-quality evidence suggests that antioxidants may be associated with an increased live birth rate compared with placebo or no treatment/standard treatment (OR 2.13, 95% CI 1.45 to 3.12, P > 0.001, 8 RCTs, 651 women, I2 = 47%). This suggests that among subfertile women with an expected live birth rate of 20%, the rate among women using antioxidants would be between 26% and 43%.Very low-quality evidence suggests that antioxidants may be associated with an increased clinical pregnancy rate compared with placebo or no treatment/standard treatment (OR 1.52, 95% CI 1.31 to 1.76, P < 0.001, 26 RCTs, 4271 women, I2 = 66%). This suggests that among subfertile women with an expected clinical pregnancy rate of 22%, the rate among women using antioxidants would be between 27% and 33%. Heterogeneity was moderately high.There was insufficient evidence to determine whether there was a difference between the groups in rates of miscarriage (OR 0.79, 95% CI 0.58 to 1.08, P = 0.14, 18 RCTs, 2834 women, I2 = 23%, very low quality evidence). This suggests that, among subfertile women with an expected miscarriage rate of 7%, use of antioxidants would be expected to result in a miscarriage rate of between 4% and 7%. There was also insufficient evidence to determine whether there was a difference between the groups in rates of multiple pregnancy (OR 1.00, 95% CI 0.73 to 1.38, P = 0.98, 8 RCTs, 2163 women, I2 = 4%, very low quality evidence). This suggests that among subfertile women with an expected multiple pregnancy rate of 8%, use of antioxidants would be expected to result in a multiple pregnancy rate between 6% and 11%. Likewise, there was insufficient evidence to determine whether there was a difference between the groups in rates of gastrointestinal disturbances (OR 1.55, 95% CI 0.47 to 5.10, P = 0.47, 3 RCTs, 343 women, I2 = 0%, very low quality evidence). This suggests that among subfertile women with an expected gastrointestinal disturbance rate of 2%, use of antioxidants would be expected to result in a rate between 1% and 11%. Overall adverse events were reported by 35 trials in the meta-analysis, but there was insufficient evidence to draw any conclusions.Only one trial reported on live birth, clinical pregnancy or adverse effects in the antioxidant versus antioxidant comparison, and no conclusions could be drawn.Very low-quality evidence suggests that pentoxifylline may be associated with an increased clinical pregnancy rate compared with placebo or no treatment (OR 2.07, 95% CI 1.20 to 3.56, P = 0.009, 3 RCTs, 276 women, I2 = 0%). This suggests that among subfertile women with an expected clinical pregnancy rate of 25%, the rate among women using pentoxifylline would be between 28% and 53%.There was insufficient evidence to determine whether there was a difference between the groups in rates of miscarriage (OR 1.34, 95% CI 0.46 to 3.90, P = 0.58, 3 RCTs, 276 women, I2 = 0%) or multiple pregnancy (OR 0.78, 95% CI 0.20 to 3.09, one RCT, 112 women, very low quality evidence). This suggests that among subfertile women with an expected miscarriage rate of 4%, the rate among women using pentoxifylline would be between 2% and 15%. For multiple pregnancy, the data suggest that among subfertile women with an expected multiple pregnancy rate of 9%, the rate among women using pentoxifylline would be between 2% and 23%.The overall quality of evidence was limited by serious risk of bias associated with poor reporting of methods, imprecision and inconsistency. AUTHORS' CONCLUSIONS:In this review, there was very low-quality evidence to show that taking an antioxidant may provide benefit for subfertile women, but insufficient evidence to draw any conclusions about adverse events. At this time, there is limited evidence in support of supplemental oral antioxidants for subfertile women.

authors

Showell MG,Mackenzie-Proctor R,Jordan V,Hart RJ

doi

10.1002/14651858.CD007807.pub3

subject

Has Abstract

pub_date

2017-07-28 00:00:00

pages

CD007807

issn

1469-493X

journal_volume

7

pub_type

杂志文章,meta分析,评审
  • Transcutaneous electrical nerve stimulation (TENS) for pain relief in labour.

    abstract:BACKGROUND:Transcutaneous nerve stimulation (TENS) has been proposed as a means of reducing pain in labour. The TENS unit emits low-voltage electrical impulses which vary in frequency and intensity. During labour, TENS electrodes are generally placed on the lower back, although TENS may be used to stimulate acupuncture...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD007214.pub2

    authors: Dowswell T,Bedwell C,Lavender T,Neilson JP

    更新日期:2009-04-15 00:00:00

  • Lobeline for smoking cessation.

    abstract:BACKGROUND:Lobeline is a partial nicotine agonist, which has been used in a variety of commercially available preparations to help stop smoking. OBJECTIVES:The objective of this review was to assess the effects of lobeline on long term smoking cessation. SEARCH METHODS:We searched the Cochrane Tobacco Addiction Group...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000124.pub2

    authors: Stead LF,Hughes JR

    更新日期:2012-02-15 00:00:00

  • Videolaryngoscopy versus direct laryngoscopy for tracheal intubation in neonates.

    abstract:BACKGROUND:Establishment of a secure airway is a critical part of neonatal resuscitation in the delivery room and the neonatal unit. Videolaryngoscopy has the potential to facilitate successful endotracheal intubation and decrease adverse consequences of delay in airway stabilization. Videolaryngoscopy may enhance visu...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009975.pub3

    authors: Lingappan K,Arnold JL,Fernandes CJ,Pammi M

    更新日期:2018-06-04 00:00:00

  • Head midline position for preventing the occurrence or extension of germinal matrix-intraventricular hemorrhage in preterm infants.

    abstract:BACKGROUND:Preterm birth is known to constitute the major risk factor for development of germinal matrix-intraventricular hemorrhage (GM-IVH). Head position may affect cerebral hemodynamics and thus may be involved indirectly in development of GM-IVH. Turning the head toward one side may functionally occlude jugular ve...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD012362.pub2

    authors: Romantsik O,Calevo MG,Bruschettini M

    更新日期:2017-07-20 00:00:00

  • Carbonic anhydrase inhibitors for hypercapnic ventilatory failure in chronic obstructive pulmonary disease.

    abstract:BACKGROUND:Carbonic anhydrase inhibitors such as acetazolamide cause a mild metabolic acidosis and may stimulate breathing. Some patients with severe chronic obstructive pulmonary disease (COPD) develop chronic hypercapnic ventilatory failure. In theory, they may benefit from use of these drugs with a fall in arterial ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002881

    authors: Jones PW,Greenstone M

    更新日期:2001-01-01 00:00:00

  • Low level laser therapy (classes I, II and III) for the treatment of osteoarthritis.

    abstract:BACKGROUND:Osteoarthritis (OA) affects a large proportion of the population. Low Level Laser Therapy (LLLT) is a light source that generates extremely pure light, of a single wavelength. The effect is not thermal, but rather related to photochemical reactions in the cells. LLLT was introduced as an alternative non-inva...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002046

    authors: Brosseau L,Welch V,Wells G,deBie R,Gam A,Harman K,Morin M,Shea B,Tugwell P

    更新日期:2000-01-01 00:00:00

  • Interventions for treating scabies.

    abstract:BACKGROUND:Scabies is a common public health problem with an estimated global prevalence of 300 million. Infestation can cause considerable discomfort and intense itching. Severe adverse effects have been reported for some drugs used to treat scabies. OBJECTIVES:The objective of this review is to assess the effects an...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000320

    authors: Walker GJ,Johnstone PW

    更新日期:2000-01-01 00:00:00

  • Micro-invasive interventions for managing proximal dental decay in primary and permanent teeth.

    abstract:BACKGROUND:Proximal dental lesions, limited to dentine, are traditionally treated by invasive (drill and fill) means. Non-invasive alternatives (e.g. fluoride varnish, flossing) might avoid substance loss but their effectiveness depends on patients' adherence. Recently, micro-invasive approaches for treating proximal c...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD010431.pub2

    authors: Dorri M,Dunne SM,Walsh T,Schwendicke F

    更新日期:2015-11-05 00:00:00

  • Optimal primary surgical treatment for advanced epithelial ovarian cancer.

    abstract:BACKGROUND:Ovarian cancer is the sixth most common cancer among women. In addition to diagnosis and staging, primary surgery is performed to achieve optimal cytoreduction (surgical efforts aimed at removing the bulk of the tumour) as the amount of residual tumour is one of the most important prognostic factors for surv...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD007565.pub2

    authors: Elattar A,Bryant A,Winter-Roach BA,Hatem M,Naik R

    更新日期:2011-08-10 00:00:00

  • Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents.

    abstract:BACKGROUND:Vomiting caused by acute gastroenteritis is very common in children and adolescents. Treatment of vomiting in children can be problematic and the use of antiemetics remains a controversial issue. There have been concerns expressed about apparently unacceptable levels of side effects such as sedation and extr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005506.pub2

    authors: Alhashimi D,Alhashimi H,Fedorowicz Z

    更新日期:2006-07-19 00:00:00

  • Trypanocidal drugs for late stage, symptomatic Chagas disease (Trypanosoma cruzi infection).

    abstract:BACKGROUND:People with Chagas disease (American Trypanosomiasis) may develop progressive and potentially lethal heart conditions. Drugs to eliminate the causative parasite, Trypanosoma cruzi, currently in use have limited therapeutic value and are used in early stages of the disease. Extending the use of these drugs to...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004102.pub2

    authors: Reyes PA,Vallejo M

    更新日期:2005-10-19 00:00:00

  • Non-nutritive sucking for gastro-oesophageal reflux disease in preterm and low birth weight infants.

    abstract:BACKGROUND:Gastro-oesophageal reflux (GOR) is commonly diagnosed in the neonatal population (DiPietro 1994), and generally causes few or no symptoms (Vandenplas 2009). Conversely, gastro-oesophageal reflux disease (GORD) refers to GOR that causes troublesome symptoms with or without complications such as damage to the ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009817.pub2

    authors: Psaila K,Foster JP,Richards R,Jeffery HE

    更新日期:2014-10-15 00:00:00

  • Single dose intra-articular morphine for pain control after knee arthroscopy.

    abstract:BACKGROUND:Knee arthroscopy is a common procedure and is associated with postoperative pain. Intra-articular (IA) injection of morphine for pain control has been widely studied, but its analgesic effect after knee arthroscopy is uncertain. OBJECTIVES:To evaluate the relative effects on pain relief and adverse events o...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008918.pub2

    authors: Zou Z,An MM,Xie Q,Chen XY,Zhang H,Liu GJ,Shi XY

    更新日期:2016-05-03 00:00:00

  • Fish oil in people with type 2 diabetes mellitus.

    abstract:BACKGROUND:People with type 2 diabetes mellitus are at increased risk from cardiovascular disease. Dietary fish oils are known to reduce triglyceride levels, but their impact on cholesterol levels, glycemic control and vascular outcomes are not well known. OBJECTIVES:To determine the effects of fish oil supplementatio...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003205

    authors: Farmer A,Montori V,Dinneen S,Clar C

    更新日期:2001-01-01 00:00:00

  • Vitamin supplementation for preventing miscarriage.

    abstract:BACKGROUND:Miscarriage is a common complication of pregnancy that can be caused by a wide range of factors. Poor dietary intake of vitamins has been associated with an increased risk of miscarriage, therefore supplementing women with vitamins either prior to or in early pregnancy may help prevent miscarriage. OBJECTIV...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004073.pub3

    authors: Rumbold A,Middleton P,Pan N,Crowther CA

    更新日期:2011-01-19 00:00:00

  • Interventions for haemolytic uraemic syndrome and thrombotic thrombocytopenic purpura.

    abstract:BACKGROUND:Haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) are related conditions with similar clinical features of variable severity. Survival of patients with HUS and TTP has improved greatly over the past two decades with improved supportive care for patients with HUS and by the use o...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003595.pub2

    authors: Michael M,Elliott EJ,Ridley GF,Hodson EM,Craig JC

    更新日期:2009-01-21 00:00:00

  • Parenteral anticoagulation in patients with cancer who have no therapeutic or prophylactic indication for anticoagulation.

    abstract:BACKGROUND:Anticoagulation may improve survival in patients with cancer through an antitumor effect in addition to the perceived antithrombotic effect. OBJECTIVES:To evaluate the efficacy and safety of parenteral anticoagulants in patients with cancer with no therapeutic or prophylactic indication for anticoagulation....

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006652.pub2

    authors: Akl EA,Gunukula S,Barba M,Yosuico VE,van Doormaal FF,Kuipers S,Middeldorp S,Dickinson HO,Bryant A,Schünemann H

    更新日期:2011-01-19 00:00:00

  • Group-based parent-training programmes for improving emotional and behavioural adjustment in 0-3 year old children.

    abstract:BACKGROUND:Mental health problems in children are common. Research suggests that parenting has an important role to play in helping children to become well adjusted adults, and that the first few months and years of a child's life are especially important in establishing patterns of emotional, cognitive and social func...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003680

    authors: Barlow J,Parsons J

    更新日期:2002-01-01 00:00:00

  • Prostaglandins versus oxytocin for prelabour rupture of membranes at or near term.

    abstract:BACKGROUND:The conventional method of induction of labour is with intravenous oxytocin. More recently, induction with prostaglandins, followed by an infusion of oxytocin if necessary, has been used. OBJECTIVES:The objective of this review was to assess the effects of induction of labour with prostaglandins compared wi...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000158

    authors: Tan BP,Hannah ME

    更新日期:2000-01-01 00:00:00

  • Quetiapine for schizophrenia.

    abstract:BACKGROUND:Quetiapine is a novel atypical antipsychotic with low propensity for movement disorder adverse effects. It is used for treatment of schizophrenia and other psychoses. OBJECTIVES:To determine the effects of quetiapine for schizophrenia in comparison to placebo, classical and other atypical antipsychotics. S...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000967

    authors: Srisurapanont M,Disayavanish C,Taimkaew K

    更新日期:2000-01-01 00:00:00

  • Bypass surgery for chronic lower limb ischaemia.

    abstract:BACKGROUND:Surgical bypass of an occluded arterial segment is the mainstay of treatment for patients with critical limb ischaemia. As with many surgical interventions, however, it was introduced without formal evaluation. OBJECTIVES:The objective of this review was to determine the effects of bypass surgery in patient...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002000

    authors: Leng GC,Davis M,Baker D

    更新日期:2000-01-01 00:00:00

  • Surgical procedures for evacuating incomplete miscarriage.

    abstract:BACKGROUND:Incomplete miscarriage is a major problem that should be effectively managed with safe and appropriate procedures. Surgical evacuation of the uterus for management of incomplete miscarriage usually involves vacuum aspiration or sharp curettage. OBJECTIVES:To compare the safety and effectiveness of surgical ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001993.pub2

    authors: Tunçalp O,Gülmezoglu AM,Souza JP

    更新日期:2010-09-08 00:00:00

  • Pin site care for preventing infections associated with external bone fixators and pins.

    abstract:BACKGROUND:Metal pins are used to apply skeletal traction or external fixation devices in the management of orthopaedic fractures. These pins protrude through the skin (described as 'percutaneous') and the way in which they are treated after insertion may affect the incidence of pin site infection. This review set out ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004551.pub2

    authors: Lethaby A,Temple J,Santy J

    更新日期:2008-10-08 00:00:00

  • WITHDRAWN: Intensity of exercise for the treatment of osteoarthritis.

    abstract:BACKGROUND:Therapeutic exercise is used as one modality to treat people with osteoarthritis (OA). OBJECTIVES:To evaluate the effectiveness of therapeutic exercise of differing intensities on objective and subjective measures of disease activity in people with OA. SEARCH METHODS:We searched MEDLINE, EMBASE, Pedro, Cur...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004259.pub2

    authors: Brosseau L,Macleay L,Welch V,Tugwell P,Wells GA

    更新日期:2013-02-28 00:00:00

  • Recombinant growth hormone therapy for cystic fibrosis in children and young adults.

    abstract:BACKGROUND:Cystic fibrosis is an inherited condition causing disease most noticeably in the lungs, digestive tract and pancreas. People with cystic fibrosis often have malnutrition and growth delay. Adequate nutritional supplementation does not improve growth optimally and hence an anabolic agent, recombinant growth ho...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008901.pub2

    authors: Thaker V,Haagensen AL,Carter B,Fedorowicz Z,Houston BW

    更新日期:2013-06-05 00:00:00

  • Allergen-specific oral immunotherapy for peanut allergy.

    abstract:BACKGROUND:Peanut allergy is one of the most common forms of food allergy encountered in clinical practice.  In most cases, it does not spontaneously resolve; furthermore, it is frequently implicated in acute life-threatening reactions. The current management of peanut allergy centres on meticulous avoidance of peanuts...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009014.pub2

    authors: Nurmatov U,Venderbosch I,Devereux G,Simons FE,Sheikh A

    更新日期:2012-09-12 00:00:00

  • Short term urinary catheter policies following urogenital surgery in adults.

    abstract:BACKGROUND:Urinary catheterisation (by the urethral or suprapubic routes) is common following urogenital surgery. There is no consensus on how to minimize complications and practice varies. OBJECTIVES:To establish the optimal way to manage urinary catheters following urogenital surgery in adults. SEARCH STRATEGY:We s...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004374.pub2

    authors: Phipps S,Lim YN,McClinton S,Barry C,Rane A,N'Dow J

    更新日期:2006-04-19 00:00:00

  • Stabilisation splint therapy for temporomandibular pain dysfunction syndrome.

    abstract:BACKGROUND:Pain dysfunction syndrome (PDS) is the most common temporomandibular disorder (TMD). There are many synonyms for this condition including facial arthromylagia, TMJ dysfunction syndrome, myofacial pain dysfunction syndrome, craniomandibular dysfunction and myofacial pain dysfunction. The aetiology of PDS is m...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002778.pub2

    authors: Al-Ani MZ,Davies SJ,Gray RJ,Sloan P,Glenny AM

    更新日期:2004-01-01 00:00:00

  • Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis.

    abstract:BACKGROUND:Postoperative nausea and vomiting (PONV) is a common adverse effect of anaesthesia and surgery. Up to 80% of patients may be affected. These outcomes are a major cause of patient dissatisfaction and may lead to prolonged hospital stay and higher costs of care along with more severe complications. Many antiem...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD012859.pub2

    authors: Weibel S,Rücker G,Eberhart LH,Pace NL,Hartl HM,Jordan OL,Mayer D,Riemer M,Schaefer MS,Raj D,Backhaus I,Helf A,Schlesinger T,Kienbaum P,Kranke P

    更新日期:2020-10-19 00:00:00

  • Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency.

    abstract:BACKGROUND:Vitamin B12 deficiency is common and rises with age. Most people with vitamin B12 deficiency are treated in primary care with intramuscular vitamin B12 which is a considerable source of work for health care professionals. Several case control and case series studies have reported equal efficacy of oral admin...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004655.pub2

    authors: Vidal-Alaball J,Butler CC,Cannings-John R,Goringe A,Hood K,McCaddon A,McDowell I,Papaioannou A

    更新日期:2005-07-20 00:00:00