A 56-year-old woman with a history of alcoholism presents with megaloblastic anemia. Which is the best treatment option?

The best treatment option for the patient with megaloblastic anemia, particularly in the context of a history of alcoholism, is a combination of oral vitamin B12 and oral folic acid. Megaloblastic anemia is primarily caused by deficiencies in vitamin B12 or folate, both of which are critical for DNA synthesis.

In individuals with a history of alcoholism, nutritional deficiencies are common, which can lead to impaired absorption of these vitamins. Alcohol can specifically interfere with the metabolism of vitamin B12 and folate. Therefore, addressing both vitamin deficiencies is essential in this case to provide a comprehensive approach to treatment.

By administering both oral vitamin B12 and oral folic acid, you effectively tackle the potential deficiencies that could be contributing to the anemia. Vitamin B12 is crucial for red blood cell production and neurological function, while folic acid is vital for DNA synthesis and the production of healthy cells. This dual approach helps ensure the patient receives adequate treatment for the specific types of megaloblastic anemia that may result from deficiencies in these vitamins, maximizing the chances for successful recovery of hematologic status.

Other treatment options, such as parenteral vitamin B12 or just folic acid alone, would not adequately address the potential combined deficiencies that can