A couple of excerpts:-
1.
In the elderly, it can cause dementia, says David Smith, Professor Emeritus of Pharmacology at Oxford University.
‘B12 deficiency is more common after the age of 60 and, once levels fall below 500 pg/ml (picograms per millilitre — the normal range being 500 to 1,000), the brain starts to deteriorate at twice the usual rate, making memory loss six times more likely,’ he says.
2.
Many people are not being diagnosed — and, when they are, they are failing to get the treatment they need, adds Professor Smith.
‘NHS guidelines insist B12 deficiency be identified by one of two possible blood tests — both of which are unreliable.
‘One test looks for macrocytic (enlarged) blood cells, which can be a sign of deficiency. The other measures the total amount of B12 in the blood. But you can be B12 deficient and sail through these tests.
‘GPs need to look for symptoms that suggest B12 deficiency — then see if these improve with B12 treatment.
'The definition of deficiency in the UK is below 200pg/ml — but harm to the brain can begin at anything below 500.’
But therein lies another problem. Most primary care trusts will fund treatment only when a diagnosis has been made.
3.
‘GPs need to consider B12 deficiency even when blood tests look normal,’ says Professor Smith.
‘They must take notice of what their patients say about their symptoms.’
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