BCSH | Vitamin B12 and folate deficiency

12th June 2014 by Louise Hudman

BCSH | Vitamin B12 and folate deficiency

This is a new guideline from the BCSH. It is quite a chunky guideline and it covers a lot of detail. I will give a few ‘top learning points’ then a more detailed summary beneath. At the end I have attached some algorithms, which are really helpful in knowing how to investigate / manage people.

Top learning points

How good is the test?

There is a lot of inter-lab variation. Using a cut-off of 148 pmol/L (200 ng/L) it has a sensitivity of 97% – so pretty good in that sense. However, some assays are affected by high anti-intrinsic factor antibody (IFAB) and can give a false normal result. If there is folate deficiency, you can also sometimes get a false normal result.

What should you do on looking at any B12 result?

What is the clinical scenario? If there was a high degree of suspicion (eg megaloblastic anaemia, neurological symptoms, glossitis), then you may not trust a ‘normal’ result and you may want to look further.

What tests should you do looking for the cause of the B12 deficiency?

Join

Join to view the rest of this content, as well as access all the benefits of joining NASGP.

Join

Login

Already a member? Login to view this content.

Login

"I rely on the NASGP for advice and support. I use LocumDeck for all my locum admin -my profile, certificates, Ts and Cs, practice contacts, booking and invoicing sessions, pension A and B forms, recording mileage and other expenses and monthly earnings.

Having been a locum in the past without LocumDeck, I realise how much easier LocumDeck makes my life, especially as I don't enjoy admin. It automates much of the admin for me. I can see at a glance how many bookings I have and where the gaps are. I have some practices who instant book me - booking directly into free sessions I have added. I have income/expenditure spreadsheets to share with my accountant.

I would highly recommend it to others."

Dr Susannah Denny

See the full list of features within our NASGP membership plans

Membership