Monday, September 28, 2009

Vitamin B12 Treatment Options: Supplementation vs. Intramuscular Injections

As a dietetic intern, I (AD) had the opportunity to present an inservice to family physicians and allied health professionals on vitamin B12 deficiency in the elderly during my placement at the Grandview Medical Centre Family Health Team (FHT). As I reviewed the literature, I became passionate about the importance of vitamin B12 deficiency diagnosis and treatment in light of the inconsistent diagnostic criteria and various treatment methods. As a result, I feel strongly that we need to raise awareness among health professionals on the need for more rigorous diagnostic criteria, as well as ‘non-traditional’ treatment methods such as oral supplementation versus intramuscular (IM) injections.


The main area of discussion during the inservice was the effectiveness of oral vitamin B12 supplementation compared to IM injections in light of the high prevalence of malabsorption due to the absence of intrinsic factor (IF) in people with pernicious anemia. IM injections have historically been the preferred treatment for vitamin B12 deficiency, bypassing the active absorption mechanism (where vitamin B12 binds to IF in the terminal ileum prior to absorption). However, the mechanism for absorption of vitamin B12 via the oral route is less commonly understood.


Oral vitamin B12 supplementation relies on free vitamin B12 to be absorbed passively without binding to IF. This accounts for 1–2% of total absorption and is unaffected in patients with pernicious anemia, gastro-duodenal surgical resection, and those with low gastric acidity (Cuskelly, Mooney and Young, 2007). Therefore, when pharmacological doses (>1,000μg) are ingested, approximately 1% of vitamin B12 (about 10 μg) is absorbed by passive diffusion exceeding the Dietary Reference Intake (DRI) requirement of 2.4μg/ day for all adults. Numerous randomized controlled trials have revealed oral vitamin B12 supplementation to be equally effective to IM injections for correcting cobalamin (B12) deficiency (Simone et al., 2005; Butler et al., 2006).


Diagnosis of Deficiency

Unfortunately, there remains no ‘gold standard’ diagnostic criteria of vitamin B12 deficiency. The most common measure for deficiency is serum B12, an unreliable and insensitive measure of vitamin B12 status (Gibson, 2005). Efforts are being made to raise the cutoff value for deficiency to effectively capture those with inadequate levels of cobalamin. For instance, at my FHT placement a serum cobalamin <130μg/l>


Because vitamin B12 deficiency is common and symptoms can be vague and similar to those experienced with aging (e.g., loss of appetite, fatigue, paleness and confusion), it can easily go undetected and untreated (Wolters, 2004). The danger of undetected vitamin B12 deficiency leading to mostly irreversible neurological and psychiatric implications emphasizes the importance of clinicians taking a closer look at vitamin B12 levels particularly among patients over the age of 50 years and those with other risk factors. Registered dietitians should recommend oral cobalamin

supplementation for those with low vitamin B12 status (<250μmol/l).


Benefits of Oral Supplementation

A Canadian cost analysis study reported a potential cost savings of $17.6 million per year by switching from IM injections to oral vitamin B12 therapy (van Walraven et al., 2001). Costs savings are attributed to decreased health care labour. Patient benefits of oral therapy include convenience of home therapy and decreased injection-related anxiety and discomfort.


People not suited for oral treatment are those unable to regularly take medications, those with short bowel syndrome, or those who have active bowel disease.


Conclusion

Following my inservice there is increased awareness at the FHT on vitamin B12 deficiency, the importance for more rigorous diagnostic criteria, and greater physician and dietitian confidence in recommending oral vitamin B12 supplementation. Reflecting on this rich learning experience has allowed me to truly appreciate the influence that research has on directing everyday practice.

I (AD) would like to thank my two preceptors, Michelle Saraiva, RD and April Hoover, RD, for their help and guidance in researching this topic and applying the evidence.


REFERENCES available from Michelle Saraiva.



Contact

Grandview Medical Centre Family Health Team
Cambridge, ON

Andrea D'Ambrosio, MAN, BASc
Masters of Applied Nutrition (MAN) Dietetic Intern
E: adambros@uoguelph.ca

Michelle Saravia, RD, MAN
E: msaraiva@gmchft.ca

April Hoover, RD, CDE
E: ahoover@gmcfht.caa

428 comments:

1 – 200 of 428   Newer›   Newest»
Suzanne said...

Good article

Claude said...

Great article! Very informative!

Gayathri Murthy said...

Very interesting article!

saraiva.michelle said...

We at Grandview (where the author interned) have been screening more of our patients for B12 deficiency, especailly those taking Metformin. As a result of using the higher cutoff of 250 pmol for interpreting the lab work, we have identified more people with low vit B12 levels and thus have been able to treat them and avoid long term deficiency. Awareness has been key! Other allied health have now been screening patients as well.

Online Pharmacy said...

Thanks for sharing such a rare information. It will help us to create awareness among people about the deficiency of the vitamin. Diagnosis of the deficiency must be done in time otherwise it can be dangerous.

dirlinigritton said...

good get-togethers, parties, or any celebration where kodiaddonstv but it can end up being also better with a few add-ons. great.

ershovayuli said...

good Unlike a DVR provider or virtually all different on-demand go to showboxdownloadz Consequently once you download and mount the BlueStacks iphone app Showbox Download App great.

Anonymous said...

good Let’s have got a search on the step by step teaching open iplaystoredownload.com It is certainly certainly not a modified variant of this request. nice.

Kelly Aniston said...

Hey!
Some friends of mine are using b12 therapy to fight their diseases. Both of them are vegans, and you don't need to be a Sherlock Holmes to multiply two and two. I even hired some writing gurus to describe this correlation for my bachelor degree paper. And it was obvious. So, my point is that you need to think twice of becoming vegan or something like this.

Unknown said...

good This lets programs you've got downloaded from anyplace other as opposed to Vidmate APK The program takes your video viewing experience. Sadly, like many nice.

Jhon said...


good Unlike a DVR provider or virtually all different on-demand
open playstoredownloadfree.co

danny donald said...

thanks for sharing playstoredownloadpc.com

Unknown said...

click

Anonymous said...

good Hope you adhered to the procedure and mounted Vidmate Vidmate APK Download I will certainly likewise be taking care of Mac customers best.

Anonymous said...

Great but additionally on computer, tablet. imo download for pc of the most secured talking application, security Fine.

Anonymous said...

good We could make use of imo application on apple iphone, Android, iPad systems. imo for windows our imo app download on COMPUTER. Following Go to All apps nice.

cathrynzbrown said...

good The Stories of stars that you have actually additionaled snapchatonlinelogine.com touch with Wi-Fi and then start sharing your image utilizing great.

cathrynzbrown said...

Great a better speed or conserve your data from people. wifikill for pc download apk follow the directions provided below Fine.

Unknown said...

Since most homes are sold, getting away from inevitable dispossession is a thing that has the most astounding need in the agenda. Awful credit home advance renegotiating could be the arrangement that could give truly necessary alleviation to hard-squeezed property holders. Payday Loans San-diego

Unknown said...

These advances are anything but difficult to renegotiate, as they can be paid in simple regularly scheduled payments. Little portions separated over a time of a couple of years are anything but difficult to make. Cash Advance

Unknown said...

However, in the event that the mortgage holder can't make a house installment, there is no cash for the moneylender, duh! Mr. Moneylender what about half of something versus 100% of nothing. Yet, the moneylender wouldn't like to trust itPayday Loans Corona

virginiadavis said...

good modify your very own music and also lip-syncing Musical.ly APK Download for Android | An Ultimate Guide video clips with friends so constantly describe nice.

virginiadavis said...

good then allow us share every little thing about it. TuTuApp is tutuapp some of the fashionable apps as well as games great.

Ngoc Tuan Timesgroup said...

Khi khoan khảo sát địa chất công trình cần tuân thủ theo nguyên tắc riêng để đội ngũ thiết kế cũng như thi công đảm bảo chất lượng công trình.

Anonymous said...

Bọc răng sứ có đau không
Bọc răng sứ kim loại quý
Răng sứ không kim loại Emax
Chỉnh nha cho răng khấp khểnh
Nha khoa uy tín tại Hà Nội
Thời gian cấy ghép Implant là bao lâu
Cấy ghép implant có đau không

nancycongdon said...

Unknown sources. This step is very important. Peggo install application YouTube to Mp3 converter. Additionally,

dellamccabe said...
This comment has been removed by the author.
dellamccabe said...

For the SHAREit individuals to claim that it is the shareit pc to share your documents docs Audio Video Image backups.

Anonymous said...

I wish that you truly suched as and appreciated this app Tutuapp APK Clash Royale, Super Mario Run, Gangstar New Orleans OpenWorld.

ruthduff said...

You have actually created a SnapChat Online Account with valid details http://snapchatapkdownload.com The very best part is, the alternatives below are completely cost-free.

https://www.usacheckcashingstore.com/san-diego said...

It requires negligible necessities. Necessities, for example, a financial balance with a decent standing, stable wellspring of pay or an occupation and IDs demonstrating that the customer is truly the person who is obtaining for the advance are all that it needs.

https://www.usapaydayloanstore.com/chicago said...

This is additionally another path for banks to persuade individuals to open checking and customary investment account.

https://www.usacheckcashingstore.com/corona said...

In the event that they need to see their cash returned, they will need to realize that the borrower is fit for completing appropriate installments.

https://www.usacheckcashingstore.com/chula-vista said...

At the point when borrowers apply for a payday credit to finance a prompt installment, they are searching for crisis help without much idea towards the result.

www.usacheckcashingstore.com/corona said...

Credit tested borrowers battle when attempting to get help for an unequal spending plan. What happens when there is a squeezing requirement for quick money and Mastercards are never again valuable?

SandraRoper said...

The app will work with your cellular phone similar to Video game Gamecih Game Cyberpunk or Game Awesome. The app calls for origin.

kajol sharma said...

Bigg Boss 11 starting date
Bigg Boss 11 Online Registration Date
Bigg Boss 11 Audition
Bigg Boss 11 Audition

Thủ thuật smartphone said...

https://cachtangchieucaonhanh.wordpress.com/
https://caolonkhoemanh.wordpress.com/
https://tangchieucaochobe.wordpress.com/

amybtarnet said...

Leapdroid for COMPUTER is basically an android emulator leapdroiddownloading that consists of a mobile device emulator that is an online mobile phone.

jimmiesdchmit said...

over time and triggers blockages, deterioration as well as shorter device life. Waterpeek - Sneaked a Peek at Water Appliances & Equipments Using a water softener will typically increase the life span.

ruthduff said...

The second would certainly be frequently facetime computer live. It's a video conferencing device.

adagmhigins said...

I hope this aids you out. Prepaid cards are gradually becoming prepaidstatus comfortably handle their all prepaid cards on the very same platform without login.

fnaf said...

I have come across and believe me I have been searching out for this similar kind of post for past a week and hardly came across this. Thank you very much and will look for more postings from you

Anonymous said...

VivaVideo is a complimentary Android video editing and enhancing application. vivavideodownload that you have to go to Settings, then Protection and also lastly when.

kristinetariasa said...

The ID number for Macy's staff member is composed of numbers. MY INSITE Macys Prior to you use for particular advantages offered by Macy's Inc, you must examine it.

Globeservations said...

Great article, thanks for sharing! Here is an awesome collection of good riddles, animal riddles and science riddles. I hope this helps you to improve your or others reasoning skills in a fun and exciting way. I really loved all the best riddles at Get Riddles.

JesseJStarkey said...

Gaming is transformed completely with the collaboration of technology and android operating system. Games have been makeover by the android platform. In doing so, app developers come up with the idea of game mod. Download Xmod mod is nothing but the bypassing of in-app purchases. In simple words, download game mod will enable the player to play the game without having to make any purchases in the game. Everything is for FREE!

Anonymous said...

Though with rise of demand and third party apps trying to develop the APK for Android devices, soon there will be a Facetime for Android available in the market facetime app android
xmodgamesdownloads.com

Anonymous said...

The 2019 AFC Asian Cup qualification was the qualification process organized by the Asian Football Confederation to determine the participating teams for the 2019 AFC Asian Cup
Womens World Cup 2019 Live Streaming
ICC World Cup 2019 Live Streaming
ICC World Cup 2019 Theme Song
AFC Acian Cup 2019 Live Streaming

Rana said...


great post admin thanks for this
kingroot apk download
http://www.kingrootapkforpcdownload.com/
http://www.tutuappapkdownloadd.com/
http://www.klitecodecspackdownloadpack.com/


aidenramirez said...

Problem of profession licences and also NoC click here to accommodate the needs of country people of the state.

Cash Advances Chicago said...

Furthermore, the present "belt-fixing" in the credit business makes this choice significantly more appealing. Here are the means by which it works. In return for an offer of your future deals, a loan supplier will give you a single amount installment in advance.

Anonymous said...

Thanks for posting keep updating

mypremiercreditcard
talktowendys
pandora apk

Jasper said...

I love the article on b12 deficiency. Many people aren't aware they may be deficient. This post is necessary. usairwaysmastercard

New Year Love 2019 said...

new year greetings 2019 for him and her

Unknown said...

The Brentwood Home Cypress Gel 13 mattress gives a great feel. it comes with a unique gel memory foam which makes this product worthy and payback the value of your money with comfortable nights with your partner.
This mattress is perfect in price range if you have the average budget but want an experience of a premium mattress then this product is made for you. All sizes of the bamboo gel are available on Amazon and bamboo gel 13 is most popular mattress among all.

Johhny said...

Magnificent, I am extremely Happy to join this network
I found here exceptionally fascinating and supportive continue sharing
you may likewise like thisget help with file explorer in windows 10

Sakir said...


thanks for proving nice content
mcdonalds wifi

mcdonald's wifi

Merry Christmas Images said...

Wendy’s is one of the celebrated fast food decision. The primary Wendy’s eatery opened in 1969 in Columbus, Ohio. The account of the fast-food chain was begun by Dave Thomas; it has been one of transient achievement. <a href="https://surveyarticles.online/talktowendys-com-wendys-customer-survey/“>talktowendys</a>

kusumreno said...

CHASE Bank Routing Numbers lists routing numbers for CHASE’s checking and savings accounts. It got popularity within a short time. It is an easiest and faster banking system.

http://bankroutings.online/chase-routing-number/

Sam said...

microg apk
microg for og youtube
iytbp magisk

Unknown said...

youtv player for pc
you tv player para iphone

ininraiclim said...

This harness showcases an easy on/off layout Dog Collars Reviews that produces hassle-free uses, and also Best Dog Collars comes total with two sturdy metal.

imo video calling app said...

Want to download IMO for PC? If yes, then you have reached your destination. In this post, we are going to tell you everything you need to know

about IMO. We will also give you a detailed guide on how you can download and install IMO in your PC right now! We will be talking about two methods

of installing imo video calling app. Both the methods are working as of now.

Venom said...

Quiero agradecerte por esta maravillosa lectura !! Definitivamente, me gusto cada parte de ello. Lo he marcado como favorito para ver las cosas nuevas que publica ... Imagenes De Año Nuevo 2019 Para Facebook

Venom said...

muito bom artigo informação legal aqui eu gostaria de visitar o site novamente Mensagem De Ano Novo Para Namorado

Venom said...

ottimo articolo bella informazione qui mi piace visitare di nuovo il sito Auguri Di Buon Anno 2019 Immagini

sideman said...

nice article

Unknown said...

Really nice setup let me tell you that i am truely inspired by your amazing work.
Wells Fargo Card Holders

ghostus said...

gb insta gram is the best app click here to download gb insta apk 2018 latest version

Rahul Kothey said...

Many cultures celebrate the occasion in some way[1] along with also the 1st day of January is frequently marked as a national holiday. Other calendars are used historically in different areas of the world; several calendars rely years numerically, while some don't.
Happy New Year 2019 Cards
Happy New Year Coloring Sheets
Happy New Year 2019 Quotes

romaniac said...

2019 NEW YEAR MEMES
happy new year 2019 memes

Anonymous said...

amazing work i enjoy your article keep checking our site New Year text Messages


Happy New Year wishes whatsapp

Happy New Year 2019 Messgaes

Anonymous said...

Amazing work Kids Christmas Jumpers

sid said...

Yes, this is amazing and awesome. thank you for posting
birthday quotes for lover

jhoni said...

Yes, this is amazing and awesome. thank you for posting.

pip camera new version 2019

Unknown said...

Also, the host nation of FIFA confederations cup 2021 that is participating in this 2019 football league of Asia wins the tournament, then the runner-up in Final Will also get qualified for the FIFA Confederations league 2021.

jhoni said...

this is amazing and awesome. thank you for posting.
.
Sketch Maker new version 2019

Venom said...

I'm really enjoying the theme/design of your site. Do you ever run into any internet browser compatibility problems? A couple of my blog visitors have complained about my website not working correctly in Explorer but looks great in Firefox. Do you have any suggestions to help fix this problem? valentinstag 2019 bilder

Unknown said...

Thanks for share ths amazxing article Nanda Nursing Diagnosis for Uti
nursing diagnosis risk for infection uti
nursing diagnosis for sepsis secondary to uti
nanda Nursing Diagnosis list for newborns
nanda nursing diagnosis for pneumonia
nursing diagnosis for type 1 diabetes
nanda nursing diagnosis for diabetes
nursing diagnosis for aspiration pneumonia

Cartoon said...

how long does it take to euthanize a cat
how much to euthanize a cat in spokane
how to euthanize a cat at home with tylenol
how to euthanize a cat at home with benadryl
how much valium to euthanize a cat
how to euthanize a cat with sleeping pills

amanda stephanie said...

Very Informative Post!Thanks For Sharing With Us.You Can Also Used Following For Getting Help In Educational Life

Make My Assignment

Assignment Help said...


This post is a pool of information. The readers are quite impressed after reading this impressive post. This impressive post certainly encourages to choose Assignment Help Melbourne. You can email us at Info@ExcellentAssignmentHelp.com.au or Phone Number: 0363877039

Happy Valentines Day 14 said...

Sister love is also very important so valentines day cards for sisters are best option.

heather said...
This comment has been removed by the author.
heather said...

The shiny black color of the jacket makes the best look of it and the leather material is soft and real to add to the extra elegance in the design of it. Round neck style with the front zipper closure. Jr. Bumblebee Black Leather Jacket/

Emma Jason said...

Thanks for sharing this piece of information. I really enjoyed it. keep up the good work and all the very best of luck! Women B3 Bomber Shearling Leather Jacket

Saina Nehwal said...

how to euthanize a pet
how to euthanize a cat

Zaidazam1997 said...

Wao great article and amazing content Valentine Week

Varun g said...

Thanks for sharing nice information with us. i like your post and all you share with us is uptodate and quite informative, i would like to bookmark the page so i can come here again to read you, as you have done a wonderful job. I found your blog using msn. This is an extremely well written article as . I will be sure to bookmark it and return to read more of your useful information. Thanks for the post. I’ll certainly comeback.

Varun g said...

I was impressed, I have to say. In fact, I rarely Encounter educational and funny blogs. You may strike a nail on your head. Your idea is wonderful. The problem is one of which is not speaking intellectually. I am pleased that I am looking for one thing

Anonymous said...

Free Recharge Tricks

WhatsApp Status

Amazon Quiz Answer

Amazon Quiz Answer

Harsh008 said...

you are truly a good webmaster. The web site loading pace is incredible. It kind of feels that you are doing any distinctive trick. Also, The contents are masterwork. you’ve performed a great activity on this subject!

Happy Valentines Day Images 2019
Happy Valentines Day Pictures 2019
Happy Promise Day Images And Quotes 2019
Happy Hug Day Images And Quotes 2019
Happy Kiss Day Images And Quotes 2019

demon smith said...

when students are new in college they face many problems.they have to focus on their subjects, participate in extracurricular activities and complete their assignments.due to this they don't have enough time to do assignments.so students assignment help provide them services of write my essay online.

HemanthSai said...

This article is actually a nice one it helps new internet viewers, who are wishing in favor of blogging. For more information https://latestgovtjobs2019.in latest news and  I absolutely love your blog and find almost all of your post’s to be just what I’m looking for. Does one offer guest writers to write content to suit your needs? https://upboard10thresult2019.com

Sravi said...

This is certainly additionally an exceedingly wonderful offer everyone truly qualified on the lookout with. It's always not likely everyday there is chances read a little something. extremely well written article as apsscresult2019.in . I will be sure to and return to read more of your useful information. Thanks for the post. I’ll certainly comeback

SGH said...

Thanks
cbseresults.nic.in
cbseresults.nic.in 2019
cbse result 2019

Unknown said...

really great post admin thanks for this post.
tech news today
imo pc
mini militia for pc
http://www.imoforpcappdownload.com/

Pankaj Singh said...

Very well written post you share here valuable information you will be share with us, it’s really helpful for me I like to read this article, thank you so much for share this awesome blog.
Jeans Supplier in Delhi

deepak ogen said...

This is a wonderful article, given me so much information on this, thanks to share this useful article with us, I really like to read this, if any one searching Web designing company in India please contact us.
Web designing company in Delhi

Cricket World Cup 2019 Schedule said...

Great article up there!

Insha said...

Punjab Education Commission result will be announced on 31st March 2019. Students can check their result through online by entering your roll number and school name. Keep in touch with us for more details about PEC result 2019.
result 2019




Result




Exams Result 2019

Kala Kutir said...

Keep on sharing more like this type article I will deeply read your article, it’s really helpful for me, I like it great job.
Lifestyle Magazine

Tausili Logoleo said...

I hope you continue to have such quality information to share with everyone! For Cricket World Cup 2019 Schedule, click here!

Unknown said...

I will suggest to my friends to visit your blog and get collect useful information it’s really helpful for me, thank you so much for share this valuable information with us, if any one searching the shipping company in India please visit our website yhcargoindia.
Sea Freight Company in Delhi

Unknown said...

Thank you for your post, I’ve been trying sarkari resultor a while but I never seem to get jobnotifys.in there! Appreciate it. :) I liked it

mobile app development toronto said...

We are the best provide mobile app development service in Toronto And Canada please visit here my website more information.

Unknown said...

This has been the persistent challenge that has baffled student’s year-after-year when it comes to checking the Up Board 12th Result 2019. Keeping the intense pressure that student’s face during the result hours, any delay is unacceptable.

Unknown said...

Teachers are not satisfied with your essay writing work. Don’t worry, our experts help you to write an essay. Our experts are highly qualified and hold master or Ph.D. digress. Hire our experts to write your best essay. Then, teachers are fully satisfied with your work. Hire Now!

Tony Stark said...

icc cricket world cup 2019 tickets
cricket world cup 2019 teams
icc world cup 2019 teams
cricket world cup 2023
icc cricket world cup 2019 schedule
cricket world cup winners
cricket world cup venues
cricket world cup 2019 prize money

sasi said...

World Cup 2019 Time Table
IPL Schedule 2019 Date and Time

Anonymous said...


Bihar Board 12th Result 2019 Announced for Arts, Science and Commerce Group BSEB Intermediate Result 2019 in School wise, biharboard.ac.in Student wise along District wise Merit Toppers lists from Bihar School Examination Board.

Navodaya Result 2019 with selected list will be announced for 5th to 6th and 7th, 8th,9th, 10th and 12th grade vacant seat admissions
JNVST Result 2019 in Jawahar Navodaya Vidyalaya, Download Navodaya 6th Result 2019 with JNV Selected
list 2019 Pdf in District wise with waiting listed candidate details.

The Navodaya Vidhyalaya Samithi is going to announced the JNVST 6th Class Result 2019 Navodaya result 2019 with Selected Candidate list for 5th to 6th class admission selection test and the NVS officials are ready to announce JNVST 9th Class Result 2019 with school wise selected candidate list for the Lateral Entry test.

Kar 2nd PUC Result 2019 check Student wise Karnataka PUC Exam Result 2019 in college wise pue.kar.nic.in and Student wise online and SMS based service
for regular and private students with school wise merit and toppers lists

Navodaya 6th Class Admission Selection Test Result 2019 Download in School Wise with Selected Candidate listJNVST Result 2019 along Division wise Merit lists, Download JNVST Result 2019 or Navodaya Result 2019 for JNV Selection list for Jawahar Navodaya Vidyalaya Admission Selection test 2019-20.



Anonymous said...


thank you for seeing to my posts Model Questions Paper 2020

yanmaneee said...

lebron shoes
jordan 6
vapormax
kd 11
Kanye West shoes
adidas ultra boost
yeezy shoes
supreme hoodie
air force 1
golden goose

Adam Thomas said...

Your article post is decent and valuable information. It is very useful for the students who need Assignment help. Programming Homework Help

Unknown said...

Therefore, socialboosts is an unconditional service of providing free Instagram Followers.

William Jacket said...

Thanks for sharing such information with us. A Good Day To Die Leather Jacket

Leather Jacket Black said...

It was so nice to read this quality stuff. Please keep posting such a great job. Brown Shearling Trench Coat

Anonymous said...

TB Electronix

Anonymous said...

After having a look at the table given above, you will be able to understand that from the past five years, BSEB Matric Result is used to be announced in the month of June. If we talk about the date then it came to know that the Bihar Board 10th Result 2019 may be announced in the 3rd week of the month.

mx male said...

keto slim
wanting to increase their appearance. Decide on a motivation for weight loss that won't allow you to quit and fuel it with passion to increase the ability of sustained success. Write it down as a reminder and stick it on your refrigerator door and your bathroom mirror. Secret #2: Nutrient and Fat Controlled Diet Among those who have successfully losing excess bodyweight and kept it off, a vitamin and fat
https://newsletterforhealth.com/keto-slim/

rajaranilove85 said...

keto lean but there are other problems you need to take into account to truly get your fat burning strategy in gear. If you are putting all your thought on the essential itself and no thought into what you eat strategy strategy or routine, you may be losing some vital points that would create weight-loss less difficult eventually. • Beginner runners often realize that they don’t decrease as many bodyweight as they
https://newsletterforhealth.com/keto-lean/

Anonymous said...

Thanks for sharing such a rare information. It will help us to create awareness among people about the deficiency of the vitamin.
old Exam Papers

Anonymous said...

Khatian and Plot Information can be checked from Banglarbhumi know your property. You can know your property information such as where it is, what part of land sum it have, whose name is this land, who is the previous owner of this land and many more, which is link on West Bengal land records website online.

myresourcepoint said...

cerisea medica -If there is an area where money can be done then you can assurance that it will be exploited. There is no those who are more exploited then those who want to lessen fat. How many many individuals have stayed, money, as well as on trying to lessen fat and not succeeded?
https://newsletterforhealth.com/cerisea-medica

seralabs cbd oil said...

Keto fit proabout. what you eat strategy strategy and will help you maintain your health and fitness and health and sense of well being. When you think much better, it shows in your height of confidence. Add The Right Kind ofCarbohydrates Fast weight-loss will happen when you add the appropriate carbs meals to what you eat strategy strategy. These carbs meals take the type of clean vegetables and fruits, clean vegetables and grain. These carbs meals should be consumed raw to avoid processing of this stuff to be able to get is, you need to be able to eat more excellent protein. tip to think
https://newsletterforhealth.com/keto-fit-pro/

Anonymous said...

good then allow us share every little thing about it.
CCLA AP VRO VRA Model Questions Papers

Result said...

Get good morning SMS

Result said...

Get good morning SMS

imo for laptop said...

IMO is a really popular video calling and chat app that you can use for absolutely free

keto advanced said...

Beta keto fruits, dry clean vegetables and fruits , and fruits juices • Running is a middle healthy and balanced and healthy and balanced execute out that can enhance your our health and fitness and health and health and fitness and burn up the calories you need to finally drop those bodyweight. Operating burns quite a few calories if you do it consistently, but there are other problems you need to take into account to truly
https://newsletterforhealth.com/beta-keto/

Anonymous said...

thanks for proving nice content Model Paper

alka tone keto said...

Keto fast levels modify very quickly and locks that were improving beyond your family lifespan enter the telogen stage presently and start to fall out. This can sometimes appear to occur all at once and can be very worrying to the new mother. Late starting reduce can be seen in dissipate thinning locks across the top
https://newsletterforhealth/keto-fast/

keto max shred said...

k shred motivation can help as well. Some individuals are motivated by the advantages that come with weight-loss, while others are motivated by wanting to increase their appearance. Decide on a motivation for weight loss that won't allow you to quit and fuel it with passion to increase the ability of sustained
https://newsletterforhealth.com/k-shred/

Anonymous said...

thanks for proving nice content
Inter Model Paper

seralabs cbd oil said...

slim quick keto
.will produce far better outcomes for you than going on a quick for weight loss ever will. There are several techniques to implement weight-loss tactics to get rid of fat quicker. Some of the following techniques are considered to be the best suggestions to get rid of fat. Any weight-loss tactics you
https://newsletterforhealth.com/slim-quick-keto

Anonymous said...

Raj 8th Model Paper 2020 Maths, Science Physics, Chemistry, Biology, English, HindiManabadi BIEAP Andhra Pradesh State Released the Model Papers. Students who are Studying Intermediate 2nd Year Model Questions Paper 2020

isaacball said...

nice post.

https://forums.cat.com/t5/Gas-Compression/G3608-Gold-Brick-Issues/m-p/92455/highlight/false#M578
https://forum.mikrotik.com/viewtopic.php?f=13&t=141885&p=699243#p699243
https://forum.graphene-theme.com/topic/favicon-site-icon-issue/
https://ficoforums.myfico.com/t5/Credit-Card-Applications/Application-Timeline-for-Amex/m-p/5444508/highlight/false#M218209
https://lithosphere.lithium.com/t5/JX-Discussions/alkaline-to-Lithium-Ion-theme-conversion/m-p/507725#M871

teal farms keto said...

keto fit pro feeds your physique system with more liquid which is always excellent to take a lot of normal water. fruits, dry clean vegetables and fruits , and fruits juices • Running is a middle healthy and balanced and healthy and balanced execute out that can enhance your our health and fitness and health and health
https://newsletterforhealth.com/keto-fit-pro/

Insha said...

Here we are going to provide you the importance of Jumma Tul Wida 2019 Status Images. Keep in touch with us for more details.

Anonymous said...

This is really awesome post and very informative there is no doubt about it.
UP Board 10th Model Paper 2020

Unknown said...

Over the past 40 years, Dr. Gerald M. Goldhaber has emerged as the nation's leading safety Warnings Expert, communication expert.

Technewssources said...

SSC Result 2019 BD
SSC Result 2019 Full Marksheet Download
SSC Result 2019 Check Online
SSC Result 2019 by SMS
SSC Dakhil Result 2019 BD
SSC Result 2019 Check by EIIN
SSC Result 2019 Publish Date
SSC Vocational Result 2019
POF Lottery 2019
HTC U13

cbseguru said...

Thank you for this post. Check out the latest uk board 12th result 2019 for Class 10th and 12th. and all the result declaration details.

Anonymous said...

nice post.
JAC 10th Model Papers

Anonymous said...

Unknown sources. This step is very important.MP Matric 10th Sample Paper

keto rapid max pure said...

elite max keto
• a right balance of nutrition while blocking your hunger for a many years. Moreover, they are delicious in taste, affordable to buy, and feeds your physique system with more liquid which is always excellent to take a lot of normal water. •
https://newsletterforhealth.com/elite-max-keto/

Anonymous said...

Thank you for this post. Model paper 2020

Adotrip Tavel Destinations in India said...

Want to plan a tour of India but don't know how to explore India or how to pretend fraud and cheat so here you can follow our blog and explore India. https://www.adotrip.com/

Anonymous said...

Great but additionally on computer, tablet.
CG Board 10th Model Paper

Anonymous said...

nice post.Hindi Questions Paper

alpha titan testo said...

mumybearrespect. Vitamin A, which has natural antibacterial properties, can help to keep down the amounts of smelly harmful bacteria that can result in a foul, fishy aroma. • Choosing the best product • Not all creams and creams are come up with same, and when it comes to promoting a appropriate and healthy
https://mumybear.org/

Unknown said...

We provide Accounting assignment help Australia services at Australiaassignmenthelp.com. We do all type of writing work. Our experts have more than 10+ years of experience in this field. Expert is any time ready for your help with cheap price.

kristen said...

Students Assignment Help provides the best dissertation statistics help with their best UK Assignment Writers. Our professional assignment writers deliver students full knowledge and understanding about the subject.

Mr. Ronan Melone said...

Great thoughts and i love the idea presented in the article. Thank you sharing the thought as i find it really very helpful.
I have found a website that provides all information related to the Cricket World Cup. i got a lot to know from that platform. You can also visit and read

Cricket World Cup 2019 Indian Team List


Cricket World Cup 2019 Schedule PDF

Cricket World Cup 2019 live Streaming Free

Keto Melt and Trim 800 said...

Keto Melt and Trim 800 works by joining raspberry ketone, garcinia cambogia, green tea, and green coffee bean concentrate to trigger a ketosis-like effect. Directly, it's basic to understand that essentially taking this exogenous upgrade (discover extra) and then spending the rest of the day eating disgraceful sustenance while sitting on the affection seat won't get you the results you're scanning for.

singapore assignment help said...

We have assignment experts who specifically help in Myassignmenthelp for students of all educational and they provide you with their assignments before delivery of time

Anonymous said...

asfdasdfasdf

dileep said...

such a great post share to me CBSE Model Paper 2020

Anonymous said...

thank you for seeing to my posts.WB 12th (HS) Blueprint

Keto Pure Review said...

I’ve recently started a blog, the info you offer on this web site has helped me tremendously. Thank you for all of your time & work.

Unknown said...

This is the perfect webpage for everyone who would like to find out
about this topic. You know so much its almost hard to argue with you (not that I
personally would want to…HaHa). You certainly put a fresh spin on a subject that has been written about
for ages. Excellent stuff, just great!

Anonymous said...

nice post.Assam 12th Admit Card

NerotenzeTestosterone said...




If some one wishes to be updated with hottest technologies therefore he must be pay a visit this site and be up to date everyday.http://sharktankreview.com/nerotenze-testosterone-australia

Anonymous said...

Thanks for sharing this piece of information. I really enjoyed it.
JNVST result 2020

Unknown said...

comprar seguidores instagram allows you to achieve incredible and fast results.

globtierinfotech said...

Thanks for sharing nice information with us. i like your post and all you share with us is uptodate and quite informative, i would like to bookmark the page so i can come here again to read you, as you have done a wonderful job. Globtier is expert in analyzing the business structure of any organization and deliver results that are far beyond your imagination and expectation. yes you hear right we are really awesome in website and development services as well as mobile app development solutions. Our services are flexible and cost cutting. We can customized website according to individual demands. Our competence and years of experience in this field can get you the expected results on time and within your budget.

Web development Services in New Jersey usa

web design and development company in New Jersey usa

best web development company in New jersey usa

Slimambition said...

Slim Ambition Keto Reviews:- Yes totally!!! Slim Ambition Keto are produced with amazing common and home grown fixings. Ist every single fixing has been chosen in this item after profound research. Along these lines, you will get the best outcome out of this item no doubt. There has been no added substances, fillers or synthetic fixings included which may give moment result however results don't keep going for a long. Be that as it may, this item is free from any added substances or fillers. This item is boundlessly helpful in nature and does not convey any antagonistic impacts. Know more>>> https://www.sharktankdietary.com/slim-ambition-keto/

https://www.facebook.com/SlimAmbitionKeto/
https://www.facebook.com/SlimAmbitionKetoReviews/
https://www.facebook.com/SlimAmbitionKetoPills/

Yasar Ali said...

You can find out some info here on cloudways 123.45

Santosh Das said...

Thanks for sharing a wonderful information with us. We work on online nagaland lottery sambad result. You can check your lottery result within a second on our website.

Anonymous said...

www.ninonurmadi.com
www.ninonurmadi.com
www.ninonurmadi.com
www.ninonurmadi.com
www.ninonurmadi.com
www.ninonurmadi.com
www.ninonurmadi.com
www.ninonurmadi.com

Unknown said...

Time to get yourself engaged with the blog sites.

Robert Smith said...

Very helpful advice in this particular post! It’s the little changes that make the largest changes. Assignment Help

Arbaz said...

Here we are going to provide you 12th Class Result 2019. Students can check their result through online by entering your roll number or through sms. 12th class result has been announced in the month of August 2019.

greek said...

Nice blog, the article you have shared is good.This article is very useful. My friend suggest me to use this blog.

surveyinfoz

ahmed said...

6- لا تتغذى على أي بيض للصراصير ، لأنه يشبه الحشرات تنمو الحشرات بسرعة ويجب استخراجها منه بالطريقة المناسبة وإزالتها على الفور
شركة مكافحة حشرات
شركة مكافحة النمل الابيض بالخبر
شركة مكافحة حشرات بالخبر
شركة رش مبيدات بالخبر

Unknown said...

Alpha Femme Keto Genix – Have you been pondering you utilizing your body weight and have you been attempting to discover all theAlpha Femme Keto Genix audits most straightforward arrangement in such manner? All things considered, you have unquestionably accompanied the ideal spot since you will become more acquainted with around outstanding amongst other ketogenic weight reduction supplements. You can't just expect weight reduction results from it yet you can likewise anticipate numerous different advantages. Alpha Femme Keto Genix is the Supplement that we will talk about today.
Read more >> https://www.sharktankdietary.com/alpha-femme-keto-genix/
Facebook >> https://www.facebook.com/AlphaFemmeKetoGenix/

teez said...

national dog day cards


national dog day celebrations
national dog day USA
national dog day Canada

Jasmine Joe said...

Grammatical errors and typos bring down your scores drastically. Our economics assignment experts have a solution for that as well. We have a team of dedicated proofreads who check your copy thrice and eliminate all the errors to deliver a flawless paper.

Unknown said...

Many of my students have been accepted to top conservatories in the nation and have gone on to successful careers as professional harpists. Harp Teachers in Northern Virginia.

Praveen said...

Really great effort and love you are extending to all, keep up your act always like this.
18 seater tempo traveller in chennai
home decorators in chennai ,
wallpaper shop in chennai

model paper said...

valuable information share to me very useful to educational peoples.Model Paper 2020

Blogs said...

Great, why don't you check out some Recharge Tricks

teez said...

national dog day captions
national dog day facts
national dog day cards


national dog day celebrations

rrb group d questions papers said...

RRB Group D Question Paper 2020 RRB Group D Model Question Paper 2020 in Hindi & EnglishRailway RRB Group D Previous Papers with Answer Questions paper 2020


Santosh Das said...

Thanks for sharing a wonderful information with us. Download Rajshree Lottery Result from our page.

Unknown said...

Have you been interested in reading the lots of information from all around the globe? Or do you wish to stay updated with the latest news? If so, then you have reached at the right BCSS8 as here you will come to know about the various facts that is linked with the latest articles posting on the high quality blogs. There are many bloggers today, which are creating the best and informative blogs in order to communicate the message from all every corner of the world.

Vivo IPL 2020 Schedule said...

Start your awesome day with A Very Google Morning Images and also check Top 10 Best Start your awesome day with A Very Tommy Hilfiger Watches and

Unknown said...

At our Portland SEO and internet marketing company, we have a team of dedicated professionals to meet all your SEO needs, from writing original content, that is valued by google’s search engine, to link building and backlinks, we understand the in and outs of search engine optimization and internet marketing Portland.

Unknown said...

And even though there are a number of different SEO Houston tactics, tools, and techniques that you can begin to leverage all on your own to enjoy real results online.

Unknown said...

It is a great site to find a number of deals on tons of items, including free baby stuff and free baby products.

Unknown said...

Staying refreshed in technology encourages you from multiple points of view. On the off chance that you are an individual, technology blogs update you with the most recent contraptions in the market.

Blueprint 2020 said...


Valuable information share to me Blueprint 2020

Anonymous said...


Nice post. Blueprint 2020

Anonymous said...

great post share to meBlueprint 2020

Unknown said...

Miracle Bust is a herbal breast enlargement product which can give you noticeable results within 2 to 4 weeks of its usage.

nickmiddleton010 said...

We carry a wide selection of top quality replacement windows and doors from today’s leading windows manufacturers, in beautiful and functional classic and modern window styles.

marvin windows pittsburgh

Anonymous said...

J&K Board Sanskrit Model Paper 2020 J&K Board Science Model Paper 2020 J&K Board Social Science (EVS) Model Paper 2020 JKBOSE 10th Class Sample Paper 2020 as we as A Whole Realize That the Jammu and Kashmir Board of School Education Leads the Tests of 10th Class in March Month Consistently.Model Paper 2020

nickmiddleton010 said...

When it comes to digital marketing, few things are as frustrating as pay per click advertising. We are here to eliminate the frustration so many business owners feel by creating successful paid search marketing campaigns that combine comprehensive strategies with consistent follow-through. PPC marketing and PPC Management is our passion, and we are very, very good at it. ppc marketing

nickmiddleton010 said...

As you probably already know, creating a brand online requires plenty of energy and focus and tasks of this type tend to eat up a lot of time. If you’d prefer to think about sales, execution and growing your company, you’ll find that investing in affordable SEO marketing services makes good sense. cheap seo packages

«Oldest ‹Older   1 – 200 of 428   Newer› Newest»