Pernicious Anaemia Society

Memory and cognitive function

Does anyone know of any information regarding B12D/PA and cognitive function? I know many of us have awful memory and brain fog type problems, and I know untreated PA can lead to Vascular Dementia. I'm aware of 'Food for the Brain's study of brain shrinkage but I'm wondering if anyone knows of anything else or have had personal experience of this.

I know a few of us have been referred to 'memory clinics' and wondered how you got on. I had my own results yesterday and don't know whether the findings are the result of depleted B12 or something else. I don't want to jump to conclusions, I'm just after better understanding.

Many thanks

7 Replies

Having been through this struggle with my sister, my advice would be to enlist the help of someone close to you and take them with you to your next appointment but, first write a letter following the templates given on:

Refuse to be referred to a memory clinic, and ask to be treated B12 injections as per the latest BCSH, UKNEQAS, NICE guidelines and summary of the BMJ research document on B12 deficiency with neurological symptoms.

I came across the website below not long ago and, reading it made me wonder why our family had such a stressful and frustrating battle last year - my sister was initially refused B12 investigation and treatment after she had been wrongly diagnosed with dementia & ME, when the information was already out there?! The consequences of ignoring B12 deficiency are catastrophic.

According to the following extracts from this document, B12 deficiency should have been considered earlier, especially with a history of vegetarianism/ME, (they wanted to refer her on to memory clinic). She refused and our letters and pleas, along with latest guidelines and information on B12 def. diagnosis and treatment, were ignored and obstructed. After many more emails and phone calls, she finally received monthly B12 injections and made a dramatic recovery but, as there is only a short window of opportunity before cognitive damage is permanent, their arrogance and ignorance caused such delay that her memory may never fully return.

......................... Extracts:

"Evaluating cognitive dysfunction requires involvement of family or other independent observers (not just the patient). "

"We attempt to define and quantify the cognitive impairment, identify any potentially reversible conditions and address comorbidities, such as vascular risk factors in hopes of preventing progression".

"Lab testing B12 levels - Methylmalonic acid/homocysteine levels (confirm vitamin B12 deficiency). Potentially reversible syndromes:

- Depression

- Medication induced

- Metabolic derangements

- Vitamin B12 deficiency

- Thyroid disorders

- Thiamine deficiency

- Chronic disease (e.g., renal failure, hepatic failure, malignancy)"

"Laboratory testing should be considered to identify potentially reversible conditions that may mimic dementia. Early identification and aggressive management of such disorders may improve a patient’s thinking and daily function. Which laboratory studies to order is controversial. Some clinicians suggest a detailed laboratory evaluation to include complete blood counts (CBC), chemistry panels, erythrocyte sedimentation rate, thyroid function tests (thyroid-stimulating hormone [TSH] and free thyroxine [FT4]), vitamin B12 level, thiamine level and syphilis screening.

Metabolic derangements:

Vitamin B12 deficiency The classic dementia work-up includes a vitamin B12 assay. Serum folate should also be measured. An estimated 10–15% of individuals over 60 years of age may be deficient [57]. Hematologic abnormalities may not occur with vitamin B12 deficiency, even with nervous system involvement [58]. In deficient states, vitamin B12 supplementation should improve mentation and prevent the disability associated with progressive myelopathy and peripheral neuropathy. Like depression, vitamin B12 deficiency is more common in AD, although it is unclear why [59]. Physicians need to monitor mental status in patients with vitamin B12 deficiency whose clinical profile is otherwise consistent with AD. If cognitive abnormalities progress even after vitamin B12 levels normalize, a diagnosis of both conditions can be made."


I have even more information but will post separately. Very best wishes for a good outcome NeedingAnswers.


Thanks for your reply but I've already been through the process of the memory clinic. It's the results from their prognosis I need to clarify. My GP's have not been very co-operative down the B12 route and in fact the clinical psychologist is supporting me with advising I go on a B12 trial.

Many thanks though :)


Yes, I read your previous post from a month ago. Is your GP still ignoring psychiatrist's advice? My sister was also referred to a psychiatrist and given medication for depression and mental problems !

You're probably aware that they would rather fob you off with drugs for depression, memory clinic, or in my sister's case ME clinic, without getting to the root of a problem, as it gives the surgery extra points and, therefore, money without being responsible for treatment !

Extract from this link:

" The two areas where each addition to the register is most

valuable are mental health and dementia care. Many of these

patients are likely to be well known to the clinicians in the practice. "

1 like

Yes, however I'm diagnosed with bipolar so I'm on meds for that anyway. But it's hard to know if the mood swings and depression are bipolar or B12. The GP surgery I'm with didn't have an available appointment for me to book, so I've still not seen anyone yet about the trial. However, after discussing this with the clinical psychologist making the assessment, I decided to take the tests before starting B12 treatment. This was to get a baseline of where I am right now. As it happens the test results have indicated I have brain damage in the area dealing with attention and immediate memory. It's usually associated with a head injury. I'll never be able to conclusively establish whether or not a B12D has caused this or not. Just trying to find out if there is a pattern to the deterioration or if others have had a similar diagnosis.


I see - I'm so sorry you are having such a difficult time and do hope you get answers must be so hard.


There's nothing I can do now, but if it could have been B12D that caused it, it really needs to be known. I don't want anyone else to end up in my position. Hence my line of enquiry.


If B12D is involved then, providing the treatment is given in the right timescales the damage can reverse.

Oxford univiersity has done a lot of research into B vitamins and dementia and this is the latest news I could find - not good news in terms of trying to use B12 as a preventative measure

However, this shouldn't be confused with the reality that B12D can manifest with dementia like symptoms and I believe the guidance for memory clinics is that B12 is something that should be followed up and ruled out.

Really hope that you get some help quickly.

1 like

You may also like...