Pernicious Anaemia Society
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B12 Deficiency Guidelines Change Date Needed For GP Letter

Hi there, I'm writing a letter to my GP but need to put correct info and I'm unsure who I can quote eg NICE or BCSH or ? as to the change to the official guidelines for treatment (especially for neurological symptoms but just within range) and the date or year they were ammended.

Have tried to work it out but still unsure and I can't cope with another face to face appointment at the moment.

It's possibly too late for tests as have been using sublingual spray but little improvement yet. Thankyou in anticipation.

5 Replies

Try reading through the documents in my summary -


according to the BCSH guidelines the version there at the moment is dated 2014.  The covering page for the guidelines states that all guidelines are reviewed every 6 months

NICE guidelines are under constant review - the relevant page in the guidelines should stated when they were last updated

1 like

Nice guidelines reviewed in July 2015.

The BNF guidelines - - don't mention when they were introduced/changed.


The BCHS guidelines are useful but your gp may say you have to see a haemo before they apply. The BNF also has the "every other day until symptoms improve" protocol for Neuro symptoms. It is probably right there on his desk but despite it being the prescribing bible they seem to be reluctant to abide by it. Your local ccg may have their own rules as to frequency of injections which is why it is not only a gp lottery but also a postcode lottery when it comes down to it.


sorry a bit late in replying to you all but it has taken me ages to compose my letter which I left  with my GP last Friday. I was totally brain dead after doing it!  I haven't had a response yet but will post the outcome. All your help was invaluable so thank you very much. I have actually asked to be referred to a Haematologist and further Thyroid testing. In and amongst this I received an appointment for neurologist - 1st of August!! I rang the hospital direct and got it brought forward to early in May. It seems that the booking service and hospitals don't necessarily work hand in hand. I have so realised that you have to be very pro-active about your treatment, which in itself is extremely fatiguing. Hoping for good news or a baby step forward.

bye for now


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