Vitamin B12 for Morning Sickness/General Malaise in a Woman with Cognitive Impairment, A Case Report

Background Morning sickness or general malaise in elderly with mild cognitive impairment (MCI) is described. General practitioners and specialists do not know a solution. In this case, empirical vitamin B12 was administered and induced a remarkable result. Case Presentation An elderly white woman had morning sickness and increasing general malaise of unkwown cause since over four years. After three years MCI and one year later extensive cognitive impairment and normocytic anemia was diagnosed. The morning sickness/general malaise was very debilitating and the cause was not known by the general practitioner and specialists. The general practitioner informed that some patients benefit from vitamin B12 injections. After the first injection, within a few days the morning sickness/general malaise vanished and it seemed as if the memory slightly improved. The effect lasted about four weeks after which the patient again started to complain about general malaise in the morning and, renewed, a vitamin B12 injection induced the same beneficial effect. After three injections, the supplement was changed to continuous oral administration. Oral administration did not lead to durable remission and the morning sickness reappeared. Renewed vitamin B12 injections again improved the morning sickness/general malaise and have since been continued at 6 to 8 weeks intervals, despite oral suppletion, as symptoms of morning sickness/general malaise reappeared at 6 to 8 week intervals. Conclusion In this case, empirical vitamin B12 resolved the morning sickness/general malaise. Although pernicious anemia could be considered, the anemia was not macrocytic. Despite, intramuscular vitamin B12 supplement had a beneficial effect.