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GPs can prescribe B12 injections following appropriate investigation, which should include: Full blood count to identify macrocytic anaemia Serum B12 and folate levels to confirm deficiency (using laboratory-specific reference ranges) Methylmalonic acid and/or homocysteine when B12 results are borderline Intrinsic factor antibodies if pernicious anaemia is suspected Additional tests depending on clinical presentation (e.g., thyroid function, coeliac serology) When both B12 and folate deficiency are present, B12 should be replaced before folate to avoid precipitating subacute combined degeneration of the spinal cord
Subcutaneous Injection Technique (Same for All Formats) Community injection protocols document standard subcutaneous technique for this class of peptide: sterilizing the injection site
Supplied as a general-purpose sterile laboratory reagent
The same protocol that produces dramatic results for one researcher may show modest effects for another
Wang L et al
Vitamin B12 deficiency can also result from poor nutrition, cancer, HIV, during pregnancy, old age, due to alcoholism
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