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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
Cyano-B12 is the most commonly used, and cheapest, form of B12 with no substantial evidence that other forms are more effective in improving B12 status
This means its absorbed faster
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Any adjustments to the 5-Amino-1MQ dosage should be made with careful consideration for animal ethics guidelines and regulatory approvals
