B12 deficiency
- Causes
- Pernicious Anaemia
- Gastric – atrophic gastritis, gastrectomy
- Intestinal – resection, malabsorption
- Dietary
- Medications – colchicine, PPIs/H2 receptor antagonists
- Apparent deficiency
- Metformin
- Pregnancy
- Oral contraceptives
- HRT
- Investigations
- Consider intrinsic factor and parietal cell antibodies
- Consider anti-TTG
- Treatment
- Patients with neurological symptoms
- Do not delay treatment
- Loading: 1000mcg hydroxycobalamin IM every second day until no further improvement
- Maintenance: 1000mcg hydroxycobalamin IM every 2 months for life
- Patients with no neurological symptoms
- Loading: 1000mcg hydroxycobalamin IM Mon/Weds/Fri for two weeks
- Maintenance:
- Non dietary: 1000mcg hydroxycobalamin IM every three months for life
- Dietary: 1000mcg hydroxycobalamin IM twice per year or 100mcg cyanocobalamin PO (if dietary deficiency is corrected, treatment can be stopped when levels normalised but ensure dietary advice given)
- Patients with neurological symptoms
- Refer B12 deficiency if
- Haematology: Pregnancy, neurological symptoms, uncertain aetiology, persistent symptoms despite replacement
- Gastroenterology: suspected malabsorption, pernicious anaemia with GI symptoms
- Dietician: concerns regarding diet
- Monitoring response to B12 replacement
- FBC and reticulocytes 10 days following initiation of treatment – check folate if no improvement
- FBC at 8 weeks to ensure normalisation of Hb
B12 raised
- Causes
- Excess intake
- Oral or IM B12
- Excess production of transcobalamins
- liver disease
- myeloproliferative disorders
- neoplasms – particular liver
- inflammation – SLE, RA
- Defective clearance of transcobalamins
- renal failure
- anti TCB antibodies
- Hepatic release of transcobalamins
- liver disease – alcohol, hepatitis, cirrhosis
- Other
- Congenital deficiency in transcobalamins
- Defect in TCB-B12 affinity
- Excess intake
- Investigations
- Physical examination – lymphadenopathy
- FBC, U+Es, LFTs inc GGT, ESR, CRP
- CXR
- USS abdomen + pelvis
- NB: transcobalmins are involved with delivery of B12 to cells
Folate deficiency
- Causes
- Dietary – often secondary to alcohol
- Malabsorption – Coeliac disease, tropical sprue, IBD, jejunal resection
- Excess requirements – Physiological (pregnancy, infancy), Haemolysis (Sickle cell), Inflammation (TB, Crohn’s), Malignancy
- Medications – Methotrexate, sulfasalazine, anticonvulsants, cholestyramine
- Metabolic
- Excess urinary excretion – CCF, chronic dialysis, acute liver damage
- Treatment
- Ensure B12 levels normal/replaced (to avoid subacute combined degeneration of the cord)
- Dietary advice
- Folic acid 5mg OD for four months (may require prolonged treatment if cause persists)
- Monitoring response to folate replacement
- FBC and reticulocytes 10 days after intiation of treatment
- FBC at 8 weeks to ensure normalisation of Hb