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undertook a double blind RCT in which a population with degenerative orthopaedic alteration with neural compression were randomised to a treatment arm of either nucleosides and B12 combination of cytidine monophosphate disodium (CMP) 2.5 mg, uridine triphosphate trisodium (UTP) 1.5 mg and hydroxocobalamin 1000 g orally ( n = 200) or a B12 only regimen of hydroxocobalamin 1.0 mg orally ( n = 200)

Food-cobalamin (vitamin B 12 ) malabsorption, first described by Carmel in 1995,30 is the most common cause of vitamin B 12 deficiency in the elderly and accounts for about 40% to 70% of cases.26 29 31 It is characterised by the inability to release vitamin B 12 from food or from its binding protein and thus, preventing vitamin B 12 from being taken up by intrinsic factor for absorption