Key Clinical Alerts
Neurological symptoms can occur without haematological abnormalities
Serum B12 can be normal despite functional deficiency - consider MMA/homocysteine
Folate supplementation can mask B12 deficiency while allowing neurological damage to progress
Nitrous oxide exposure (including recreational use) can precipitate acute B12 deficiency
Clinical Resources
Tools and resources designed for busy clinicians.
Guidelines Summary
Quick reference to NICE, BNF, and BSH guidelines on B12 deficiency diagnosis and management.
Evidence Library
Curated collection of peer-reviewed research, systematic reviews, and clinical studies.
Key Guideline Highlights
NICE Clinical Knowledge Summary
Investigate if macrocytic anaemia OR neurological symptoms suggesting B12 deficiency
British National Formulary
Hydroxocobalamin 1mg IM three times weekly for 2 weeks, then every 2-3 months
BSH Guidelines
Treat if symptomatic even with borderline serum B12 (below 300 ng/L)