I am particularly concerned with this individual G.P.’s practice, Dr Ansari of Cliff House Medical Practice, Lincoln of Leicester, Leicestershire, Rutland and Lincolnshire Integrated Care Systems & NHS Trust has ONLY been a GP Partner for 5 years. He is unwilling to learn from experts in their field.
He has stated in his letter that ‘the other potential underlying causes for such symptoms such as perimenopause, CFS/ME, chronic poor mental health and other nutritional deficiencies.’
Now, I am fully aware that Nackapan’s journey of vitamin B12D commenced with the ‘trigger’ appearing to be the menopause. Many of us, have had nonsense misdiagnoses blaming poor Mental Health (MH). Symptoms of depression and anxiety are regarded as diagnoses. So, therefore, can be found in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. As a consequence of misdiagnoses, incorrect treatment occurs which are Drug Errors and Mismanagement happens too.
Patients are sent to Chronic Pain Clinics and have Cognitive Behavioural Therapy. I see from this particular doctors’ curriculum vitae, they have a specialist interest in Mental Health. Therefore, believe that they know about care and treatment for patients who display symptoms of bipolar, schizophrenia and Major Depressive Disorder. They clearly have no knowledge of why Mr. P Julian Owen takes a special interest.
Dr Ansari is a Transformation Lead in Mental Health. Therefore, he really needs to understand and treat vitamin B12 deficiency because it can result in patients :-
Being detained under the Mental Health Act (1983),
Taking their own lives, suffering from delusions, hallucinations, aggression and personality changes.
Currently, Dr Ansari is NOT transforming ANYTHING.
He is very unwilling to take on board new research.
So, is not keeping up to date with his own Clinical Practice.
He very wrongly believes that it is ‘Time to Talk’ with the MH campaign ‘Get the Picture.’
It is you, Doctor who is way off the mark.
Now, unfortunately, Reehan, I am the epitome of stubborn with a capital S. You, doctor are forgetting the medicolegal notes that you produce are auditable.
In 2015, via this method, Dr Stephen Breary and Dr Ravi Jayaram identified a highly dangerous clinician. She did not care for tiny, vulnerable babies.
You, Dr Ansariare also forgetting ‘Acts of Omissions’ which are otherwise known as Actus reus or in the U.S.A, Mens Rea - translated from Latin to Guilty Act.
"Most, if not all, GPs will be able to recount stories of people who have been prescribed lifetime B12 supplementation for borderline results leading to situations where they become incredibly symptomatic through administration of B12 injection that is 2-3 days late."
The GP seems to be making 2 implicit assumptions here
(1) These persons were never "really" B12 deficient in the first place and were treated unnecessarily. How can he be sure about this since the diagnostics are so poor and he should know that "borderline B12" does not discount significant neurological damage.
(2) That the treatment has created some situation where the body is dependent on higher and more frequent amounts of B12 than are physiologically necessary, due to the injections in and of themselves.
Interesting theory but where is the research or evidence that this is what is happening? One could make competing speculations based on issues with liver mobilisation and bile recovery but would have as much basis for those as he does for his idea. He agrees we need more research but yet here he implies definite knowledge of whats happening with regards to the need for very regular injections with PA - please enlighten us on the mechanisms good doctor!
I appreciate his frustration that diagnosis of B12 deficiency and PA can be quite difficult (but not always!) but the consequences of not treating a deficiency or PA are so much more serious . Besides which, OTC injectable B12 would mean not being reliant on such really crappy diagnostics as they can bring to bear right now.
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Recent bmj article - patient preferences 
Vit B12 and Bone Marrow problems
BMJ Best Practice website advice on B12 deficiency
