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Vitamin B12 Deficiency

A fairly common presentation in Primary care in the UK. The chart on A4Medicine presents the user with the current guidance and evidence in the management of vitamin B12 deficiency in the UK. The guidance from British Committee for Standards in Haematology is presented for quick reference. Pernicious anaemia is the most common cause of vitamin B12 deficiency in the UK. Other causes as Crohn’s, pancreatic insufficiency and drugs notably metformin and proton pump inhibitors have been cited. Clinical manifestations of vitamin B12 deficiency – namely neurological ( as subacute combined degeneration of the cord – SACD ), haematological, tongue are displayed clearly for the GP to review. Current consensus on referral and treatment is discussed and the GP should also take into account any local guidance available in the management of Vit B12 deficiency. Once the B12 replacement is commenced further testing of B12 levels is not recommended.

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