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Diagnosis and treatment of B12 deficiency

Diagnosis and treatment of B12 deficiency


Why this is important

In the UK, and across the world, diagnosis and treatment of B12 deficiency is far from ideal. In diagnosing the deficiency there is no gold standard for testing, with the present blood test often failing to detect deficiency, leading to debilitating neurological symptoms; which are often overlooked because medical professionals look for macrocytosis that does not always occur. UKNEQAS issued an alert stating categorically to treat patients due to the risk of irreversible nerve damage - yet this is still ignored. B12 serum blood tests are an unreliable indicator of deficiency putting people at risk of permanent neurological damage.

When, or if, a patient is finally diagnosed, often they receive injections once every 3 months after an initial loading dose, which is far from adequate. Guidelines issued by BNF (9.1.2) are routinely ignored even when patients experience overwhelming neurological issues.!scenariorecommendation:4 In the UK there are zero specialists available to help sufferers, often they begin a crazy carousel of referrals from one consultant to another - with many consultants oblivious to the symptoms of b12 or how to help, with many believing that this water soluble nutrient is toxic.

This is not the end of the problems experienced. For those that do not respond to the form of B12 used (hydroxocobalamin in the UK) to replace the B12 that can no longer be absorbed by the body, they are ignored, with no access to alternatives (such as methylcobalamin) that could help them because it is not licensed for use in the UK even though scientific literature has proven time and again that different forms of active b12 are better for recovery from debilitating disabling symptoms. Treatment is controlled via gp surgeries, whereas in Europe sufferers have access to this vital nutrient over the counter.

Treatment should be per individual, based upon symptoms, with the option of various forms of active b12 available and over the counter so that sufferers can take control of their condition. Instead, patients are left with overwhelming symptoms that could be relieved with individualised treatment plans accessing injections as frequently as needed; enabling sufferers to lead normal healthy lives instead of the disabling experiences they presently encounter.

Access to vital B12 injections (a vital nutrient).and the whole ethos around the condition urgently needs to be addressed and the medical community needs to wake up to what they are doing to patients by denying access to treatment. The Health Department in the UK are well aware of the issues with B12d and have still done nothing to help thousands of people suffering needlessly. This madness needs to stop, allowing patients to take control of their own health, allowing access to injections when needed - be it daily, weekly, monthly; for alternatives to be openly available, and all patients given individual care plans to enable them to regain their lives from this disabling condition.

Posted April 10, 2013
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