Hi,
I'm off to Nepal in a couple of days for 3 weeks+ for a high altitude trek. I already self inject - officially monthly, but I supplement with my own B12 supplies from mycare.de and usually inject every 2 weeks.
Due to the trip I wanted to take a couple of vials/needles with me so I can inject there, so requested a note from the Doctor to say I am authorised to have the medication.
Doctor called me back and basically refused to write the note on the basis that my levels (2000+) mean I already have enough B12, that I don't need it as often as I am taking it and that he can't sanction it.
I tried mentioning the problems with the serum level test and it not being an indication of what you have available at the cellular level, but he just kept going back to my serum levels being very high and therefore I don't need anymore.
He did mention we could review my levels when I got back and do a complete blood count which if it showed my B12 levels as ok along with MCV / HBC, folate then that would prove it I had enough / don't need to take as much as I do.
I did try mentioning the BNF guidelines about not sticking strictly to the serum levels and also queried whether the full blood count would include MMA levels - amusingly he didn't know what MMA was!
I do feel like perhaps I should have kept my mouth shut about injecting as often as I do as now the cat is out of the bag, but as I get my supplies from Germany, the worse they can do is stop my NHS prescriptions.
He did mention possibly referring me to the Gastroenterologist who diagnosed my PA originally if I came in to have my levels checked, but suspect he'll just say they're fine therefore no need. Would like to see the Gastro however to discuss my Gastro symptoms, so not sure whether to do this or not.