Publications referring to how serum b12 measurements after loading doses shouldn’t be a reference point for clinical decisions

[Dexy123]

I was wondering if anyone knows of a journal publication which refers to the fact that serum b12 measurements after loading doses should not be used as marker for whether someone has an absorption issue or not? Especially when the patient has never been vegan or vegetarian!

I have the BMJ 2020, Mohammed et al paper which is really useful, but doesn’t give much strict guidance on serum b12 interpretation post injections. Thanks

[Gambit62 Administrator]

pretty sure it is in here somewhere but can't find it at the momentonlinelibrary.wiley.com/doi...

[Gambit62 Administrator in reply to Gambit62]

is definitely herecks.nice.org.uk/topics/anae...

Measuring cobalamin levels is unhelpful as levels increase with treatment regardless of how effective it is, and retesting is not usually required.

However, cobalamin can be measured 1–2 months after starting treatment if there is no response.

[Dexy123 in reply to Gambit62]

Perfect, thank you - it’s feedback for two haematologists who used my post loading high serum b12 results as a guide that everything is now fixed.

[Gambit62 Administrator in reply to Dexy123]

Think they need to take a step back and apply some common sense - they know that the loading shots will raise B12 through the routes and then it will fall so the circumstances that applied when the normal range was set just don't apply but sometimes it can take a while to engage brain

[Jillymo]

Hi Dexy,

The idiots did exactly the same with me and tested a couple of days after I had had my shot - hey ho ecerythings fine despite I was feeling awful.

After kicking up a fuss I am now being given 2 monthly injections which should be every 56 days but they are running over that time and not giving when they should. Dr informs me this is ok and will not make any difference. 😱

I have been really ill due to this and have tried to explain if I were a diabetic my medication would be given on time and my B12 is just as impotant.

It seems to be a constant battle but know how you feel.