the parenteral administration of a cyanocobalamin compound having the general structure and coenzyme activity of vitamin b 12 is capable of reducing the serum levels of reaginic antibody , i g e , found in many patients suffering from allergic disorders , thereby providing these patients with long term relief from their symptoms . patients who are likely to benefit from the therapy are those who have experienced allergic attacks of rhinitis or extrinsic asthma , and whose serum levels of i g e are significantly above normal . these patients may accordingly be identified by medical history and by a quantitative determination of total non - specific i g e levels by a immunoassay procedure , such as phadezym i g e prist . the level of i g e response to a specific allergen , where that allergen is known , may be determined by a corresponding rast immunoassay ( pharmacia , piscataway , n . j .). specific i g e levels may also be qualitatively demonstrated by the &# 34 ; wheal and flare &# 34 ; response of conventional skin testing . patients suffering from allergic bronchial asthma may receive a collateral pulmonary function test ( plf ). the primary therapeutic agent is cyanocobalamin or any of its derivatives or analogs having the coenzyme activity of vitamin b 12 . hydroxy - cyanocobalamin has the advantage of being less rapidly excreted in the urine than other species . treatment by injection is essential ; oral administration of vitamin b 12 alone has been found to be ineffective . in a preferred regimen , vitamin b 12 , as cyanocobalamin , is administered subcutaneously at a dose of 15 μg , in a volume of 1 cc , every 12 hours for 15 consecutive days . the dose may be in the range of from about 5 to 50 μg , and the duration of treatment from about 3 to 45 days . the two daily doses may also be administered at an 8 hour interval . in an alternate embodiment of the invention , the parenteral vitamin b 12 therapy is combined with the oral administration of b complex vitamins b 1 , b 6 , and b 12 as well as vitamin c . the b complex vitamins are given in doses of 50 to 200 mg b 1 , 50 to 500 mg b 6 , and 10 μg to 2 mg b 12 , vitamin c is given in a dose of from 1 to 10 gm . in a preferred embodiment , 100 mg of b 1 , 250 mg of b 6 and 1 mg of b 12 are taken orally twice daily , and 4 grams of vitamin c are taken once daily , at least two hours before or after the b complex are separated in order to prevent a destructive action of vitamin c on the b complex . when the injections are supplemented with oral doses of vitamins the treatment is effective in a larger proportion of patients and the relief from symptoms more long - lasting . therapy of patients is monitored by the prist and rast tests as well as plf studies . therapy is most effective if it is begun while patients are asymptomatic ; however , if symptoms appear during the course of treatment , they may be treated by conventional methods and the vitamin therapy need not be interrupted . parenteral low level vitamin b 12 therapy are conventionally employed as a specific treatment for pernicious anemia . however pernicious anemia and atopic allergy are distinct in pathogenesis and the mechanism by which vitamin b 12 alleviates symptoms in each disease is likewise distinct . pernicious anemia results from a lack of sufficient &# 34 ; intrinsic factor &# 34 ; in the intestine to allow absorption of vitamin b 12 . it results not only in anemia , but also digestive disorders and neurologic damage . intramuscular injections of vitamin b 12 of 1 μg or more daily provoke a rapid response , with new blood cell formation ( reticulocytosis ) apparent in a few days . because of the intrinsic factor defect , injections of about 100 μg must be given every month for an indefinite period . atopic allergy , by contrast , is caused by a disorder in the immune system , resulting in the inappropriate reaginic response to harmless agents . vitamin b 12 , in the mode of therapy defined in this invention , acts to correct this disorder so as to give long lasting relief of symptoms , if not a cure . the administration of vitamin b 12 need not be continued indefinitely to achieve the result . the mechanism by which vitamin b 12 receives atopic allergy is uncertain , but a reasonable hypothesis may be constructed . vitamin b 12 is known to be essential to human nutrition , and its deficiency particularly affects the nervous system , resulting in degenerative changes and gross disorders in function . the inappropriate immune response of atopic allergy has been experimentally linked to an imbalance in the function of the autonomic nervous system . animals which lack the ability to demonstrate anaphylaxis , an extreme manifestation of allergy , can be induced to this hypersensitive state by using agents that block the action of one branch of this system , preventing a beta - adrenergic response . consequently the sympathetic ( beta - adrenergic ) and parasympathetic ( cholinergic ) systems become unbalanced when beta - adrenergic blockade occurs , and antibody formation also shifts from normal i g g and i g m synthesis to that of i g e . human asthma patients respond with symptomatic relief to drugs such as metaproterenal , which enhance betaadrenergic response . an autonomic imbalance with betaadrenergic defect , overactive cholinergic control , and elevated i g e levels ( similar to the condition induced in laboratory animals ) could result in disturbed homeostatic control of adrenergic receptors controlling the smooth muscles of the bronchi . conceivably the mechanism of effective vitamin b 12 therapy in extrinsic asthma involves a restoration of normal homeostasis of the autonomic nervous system . a more complete understanding of the invention can be obtained by referring to the following example , which is not intended , however , to limit the invention . a group of ten patients were selected for study from a population of those with a history of allergic rhinitis or allergic bronchial asthma . on the basis of screening tests for specific and non - specific i g e , it was determined that each patient selected had levels of either or both of these types of reaginic antibodies substantially above the normal range . in this group of ten patients , seven ( fl , il , em , jm , pr , mt and ju ) were asthmatic ; two ( tc and ar ) had suffered from rhinitis and bronchitis with bronchospasm ; one ( aa ) suffered from perennial allergic rhinitis . specific allergies were known for five of the patients ( aa , il , em , pr and mt ). both em and mt had previously undergone desensitization therapy . all patients were treated with two subcutaneous injections of vitamin b 12 per day , as 15 μg of cyanocobalamin ( natural extract of calves liver ) in 1 cc . of distilled water . injections were given for a period of 15 days . five of the patients ( aa , il , em , pr and ju ) were given supplemental doses of vitamin b 12 and 4 grams of vitamin c daily during the couse of treatment . table 1 shows the immunoassay results for nonspecific and specific i g e levels in these patients before and after therapy . all patients showed significant reduction in i g e levels following therapy . the table also includes non - specific i g e levels of two patients , ha ( 66 year old male ) and ga ( 67 year old female ) who had been lifelong sufferers from these types of allergies until they underwent this therapy in spain in 1977 . since that time they have been symptom free . the prist total i g e levels for these two patients are in the normal range . in table 2 , pulmonary function studies for fl show that the moderate airway obstruction existing before the treatment was eliminated and a normal breathing pattern restored . table 1__________________________________________________________________________response of patients to vitamin b . sub . 12immunotherapy as determined byassays for serum levels of immunoglobulin i . sub . g e prist i . sub . g e rastpatient sex / age 0 1 2 3 0 1 2__________________________________________________________________________aa f42 650 325 310 160 g × 2 -- 0 . 8 2 . 0 w × 1 -- 1 . 33 -- h × 2 3 . 0 2 . 0 -- e × 1 0 . 66 -- 0 . 66 t × 3 -- 7 . 0 1 . 66tc f21 850 400 430 491 g × 2 -- -- -- w × 1 1 . 08 -- -- h × 2 78 70 8 . 28 e × 1 0 . 33 0 . 66 -- t × 3 5 . 0 2 . 0 -- fl m73 430 190 g × 2 2 . 0 -- w × 1 1 . 83 -- h × 2 4 . 0 -- e × 1 -- t × 3 2 . 0 -- il f23 90 65 g × 2 0 . 8 -- w × 1 0 . 66 0 . 66 h × 2 -- 0 . 57 e × 1 2 . 0 0 . 33 t × 3 0 . 33 0 . 33em f43 60 67 . 5 g × 2 -- -- w × 1 1 . 33 -- h × 2 3 . 71 -- e × 1 1 . 33 -- t × 3 -- -- jm m31 300 375 145 g × 2 -- 0 . 4 w × 1 -- -- h × 2 8 . 0 6 . 0 e × 1 2 . 0 1 . 0 t × 3 -- 5 . 5ar m59 1300 450 263 g × 2 1 . 2 1 . 8 w × 1 0 . 33 -- h × 2 -- 10 e × 1 -- -- t × 3 -- 2pr f29 950 425 g × 2 2 . 0 2 . 2 w × 1 0 . 83 1 . 66 h × 2 16 . 28 18 . 28 e × 1 0 . 66 1 . 33 t × 3 -- 1 . 0mt * f35 230 135 95 93 g × 2 -- -- -- w × 1 -- -- -- h × 2 4 . 0 10 . 0 1 . 14 e × 1 -- 1 . 0 -- t × 3 -- 2 . 0 0 . 33ju f65 30 60 g × 2 1 . 2 -- w × 1 1 . 0 0 . 66 h × 2 0 . 57 -- e × 1 -- 1 . 0 t × 3 0 . 66 -- long term symptom - free patientsha m66 70 g × 2 -- w × 1 -- h × 2 -- e × 1 1 . 0 t × 3 2 . 0ga f 57 . 5 g × 2 -- w × 1 -- h × 2 -- e × 1 -- t × 3 -- __________________________________________________________________________ *( pt experienced asthma attack on day 15 of treatment )&# 34 ; 0 &# 34 ; determinations before initial treatment ;&# 34 ; 1 &# 34 ; = 14 - 21 days later ;&# 34 ; 2 &# 34 ; = 45 - 60 days later ;&# 34 ; 3 &# 34 ; = 150 days laterprist test : values are in ku / l mean i . s . d . 2 . s . d . normalage 31 - 50 years 19 79 324ranges , 51 - 80 years 12 48 197rast test : values are in pru / mlnormal value : not detected (--). allergen - specific control = 2pru / ml . g × 2 = grass pollenw × 2 = weed pollenh × 2 = house duste × 1 = animal dandert × 3 = tree pollen table 2__________________________________________________________________________ postbronchodilatorprebronchodilator pre - % %** spirometry ** actual pred . dicated actual pred . change__________________________________________________________________________pre - treatmentfv ( liters ) 1 . 93 57 3 . 37 3 . 02 90 57fev - 1 ( liters ) 1 . 57 58 2 . 70 2 . 29 85 46fev - 1 / fvc (%) . 82 . 79 . 76 - 7fef25 - 75 ( l / sec ) 1 . 40 52 2 . 70 1 . 84 68 32pefr ( l / sec ) 4 . 94 66 7 . 45 6 . 53 88 32fef25 ( l / sec ) 2 . 63 39 6 . 80 5 . 09 75 94fef50 ( l / sec ) 1 . 50 44 3 . 42 2 . 30 67 54fef75 ( l / sec ) . 69 61 1 . 13 . 55 48 21 &# 34 ; moderate airway obstruction &# 34 ;- post - treatmentfvc ( liters ) 3 . 30 95 3 . 47 3 . 55 102 8fev - 1 ( liters ) 2 . 38 86 2 . 78 2 . 57 92 8fev - 1 / fvc (%) . 72 . 79 . 72 0fef25 - 75 ( l / sec ) 1 . 66 60 2 . 77 1 . 76 63 6pefr ( l / sec ) 8 . 93 118 7 . 57 8 . 41 111 - 6fef25 ( l / sec ) 3 . 57 52 6 . 91 4 . 71 68 32fef50 ( l / sec ) 2 . 07 59 3 . 50 2 . 03 58 - 2fef75 ( l / sec ) . 56 48 1 . 17 . 58 49 3__________________________________________________________________________ &# 34 ; normal spirometry &# 34 ;- the invention may be embodied in other specific forms without departing from its spirit or essential characteristics . the described embodiments , therefore , are to be considered in all respects only as illustrative and not restrictive . all changes which come within the meaning and range of equivalency of the claims are to be embraced with their scope .
a method for achieving long term relief from the symptoms of atopic allergy , comprising parenteral administration of vitamin b 12 to selected patients , is produced . vitamin b 12 acts to reduce the levels of reaginic antibody in these patients , and this effect persists beyond the period of treatment . the regimen may include oral administration of vitamin b 12 as well as other vitamins .