Dear Editor,
I was interested to read this article on B12 deficiency, which I noted had no GP in the author list, even though this is an almost exclusively General Practice diagnosis with all treatment being delivered through Primary Care.
There is an omission, from my perspective, for the need to critique and specifically analyse the presenting symptoms associated with B12 deficiency, the other potential underlying causes for such symptoms such as perimenopause, CFS/ME, chronic poor mental health and other nutritional deficiencies.
The neurological symptoms are so vague that they basically support supplementation in all psychiatric patients and about 50% of all GP presentations. Both sets of these patients, depending on the area, are more likely to be nutritionally compromised)
We risk veering into the realms of ‘wellness’ rather than ‘health’ if we start offering injectable B12 supplementation to all with a B12 less than 300 who are feeling fatigued or have brain fog.
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. There is also the mistaken diagnostic issue of B12 deficiency = pernicious anaemia (a much more significant diagnosis).
This article has been written to support access for patients to receive B12 supplementation when they need it, which is a helpful addition to the literature, but does nothing to empower doctors who actually encounter this presentation to be able to bring some objectivity or certainty to the diagnosis. Further research is certainly indicated into this phenomenon with a hope that B12 deficiency as a medical problem can be fully separated from the syndrome of someone who feels B12 deficient. The former should be treated medically and the offer can have treatment undertaken privately as they would for other vitamin treatments.
Kind regards
Re: Vitamin B12