article in the times

[Hedgehogs15]

One word of caution. A course of high-dose supplements given for at least three months will resolve many deficiencies but, unless diets/medication/underlying conditions change the problem is likely to recur. Many people will require lifelong supplements or, at the very least, future testing to check they are maintaining good levels.

Due to changes in NHS prescribing, some people with low B12 levels will be advised to buy their own over-the-counter supplements, rather than be offered them on prescription. If this applies to you then I would opt for sublingual supplements designed to melt under your tongue (or in your cheek) as these may help absorption if you are on an antacid, have low IF activity or an underlying bowel problem.

However, whatever pathway you end up on for your deficiency, the journey will only start if you, or your doctor, requests a blood test. So who should be tested? I have summarised Nice’s suggestions below, and you can read the full draft guideline at nice.org.uk.

B12 deficiency

The draft guidance from Nice advises offering a B12 blood test to people who have at least one symptom and at least one risk factor.

Symptoms/signs include: 
● Abnormal findings on a blood count, such as anaemia
● Cognitive difficulties, including memory problems and other symptoms of dementia
● A sore/inflamed tongue
● Unexplained eyesight changes, including blurred vision
● Mental health problems, such as anxiety and depression
● Neurological symptoms, including impaired balance, weakness, pins and needles or numbness
● Unexplained fatigue.

And risk factors include:
● Age over 65
● A diet low in B12 (eg vegan)
● A family history of vitamin B12 deficiency or an autoimmune/underlying health condition such as coeliac disease, thyroid problems and type 1 diabetes
● Taking some types of medication, including anti-seizure medicines pregabalin, primidone and topiramate, the gout pill colchicine, “antacids” such as omeprazole, and metformin for type 2 diabetes
● Previous abdominal or pelvic radiotherapy, or gastric/bowel surgery
● And, while unlikely to apply to many Times readers, for completeness: recreational nitrous oxide use.

I managed to copy the rest of the article for us x

[bookish]

Thank you for that. How a straight serum is supposed to pick up anyone with Nitrous use fails me and you rather wonder if they will check multivitamin or B complex use and know that may distort results, as well as B12 fortified foods. Hopefully holotc will be used too, but we know you need a full panel of tests to be reasonably sure of no deficiency and I can't believe that will happen. Best wishes