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Vitamin B12 is essential for the production of red blood cells, the maintenance of the nervous system, and the synthesis of DNA

doi: 10.1038/ejcn.2014.46

The textbooks describe a stepwise approach from mesalamine or sulfasalazine, through systemic prednisone with or without an immunomodulator (such as azathioprine, methotrexate or 6-mercaptopurine), to TNF-alpha inhibitor biologics, injectable medicines that block a key inflammation signal (infliximab, adalimumab, golimumab or certolizumab pegol), the IL-12/IL-23 inhibitor ustekinumab, or the anti-adhesion antibody vedolizumab for refractory disease

Measuring mucosal healing, cytokine levels, and tissue histology in combination protocols would clarify potential interactions

Community experience does document common side effects including injection site reactions, occasional headaches, and digestive changes