Following NHS guidelines, the practice is looking into patients who are currently taking B12 injections and identifying those who are suitable for swapping to oral maintenance where appropriate to maintain levels. (Please see info below) If you feel that you do not met the criteria please make a routine appointment to discuss.
Vitamin B12 or folate deficiency anaemia - NHS (www.nhs.uk)
B12 deficiency
The problem is that modern diet is so low in B12 that deficiency rates are increasing. This is not due to poor absorption - lacking Intrinsic factor (Pernicious anaemia) – it is largely due to low amounts in the diet.
As per local guidelines, patients are being reviewed as to whether they are suitable for low dose Oral Vitamin B12 instead of intramuscular injections to MAINTAIN their levels.
The guidelines advise that b12 injections can be used at the start to INCREASE low levels in the body. However, most people have a low b12 as a result of a dietary cause. And these people can MAINTAIN their B12 levels with either low dose oral B12 tablet or diet changes alone.
People not suitable for Oral switch
Currently, people who have Neurological involvement as a result of low B12; conditions where it is poorly absorbed (such as pernicious anaemia); or Previous gastric surgery, are to remain on intramuscular injections.
Other conditions are as follows (List not exhaustive):
- Gastric:
Total or partial gastrectomy, congenital intrinsic factor deficiency or abnormality, Zollinger-Ellison syndrome.
- Inherited
Intrinsic factor receptor deficiency (Imerslund Gräsback syndrome), congenital intrinsic factor deficiency (juvenile pernicious anaemia), cobalamin mutation, transcobalamin deficiency.
- Intestinal
Malabsorption (for example gluten-induced enteropathy), ileal resection, Crohn's disease, blind loop syndrome, parasites (for example, giardiasis, fish tapeworm).
If you have been contacted and feel that you have been placed on oral tablets incorrectly, please contact the surgery to make a routine appointment for review.
Medications change
Your script for B12 injections will be stopped, and a script for oral replacement will be sent to your registered pharmacy. You are able to start taking the oral replacement tablets immediately.
You may be sent a further message to have a specialised blood test performed for pernicious anaemia if there are no records of this on the system. If positive, you will be swapped back to the Intramuscular injections, and if negative will remain on tablets.