13 Jul 2023 • In a groundbreaking move, the National Institute for Health and Care Excellence (NICE) has released its first-ever draft guidelines for diagnosing and managing vitamin B12 deficiency. The guidelines emphasize the importance of considering intramuscular injections for individuals with concerns about adherence to oral replacement. 🎉

The elderly, especially those aged 65 and above, are particularly vulnerable to vitamin B12 deficiency, with an estimated one in ten individuals over 75 affected. Left untreated, this deficiency can lead to a range of health complications, including anemia, fatigue, eyesight problems, mobility issues, and delirium. 😔

Key takeaways from the guidelines: Diagnosis: Blood tests should be offered if one sign or symptom, along with one or more risk factors such as age or previous digestive system surgery, are present. Inconclusive results may require additional testing, including methylmalonic acid (MMA) tests. Treatment: Intramuscular injections or oral replacement should be considered based on the identified cause. Regular vitamin B12 concentration tests are crucial for monitoring effectiveness. Adherence Concerns: Intramuscular injections are recommended for individuals with adherence issues, such as older patients with complex comorbidity or frailty due to undernutrition, dementia, or decompensation.

By implementing these guidelines, clinicians can better address the needs of high-risk patients with vitamin B12 deficiency, ensuring improved outcomes and enhanced quality of life. 💪💊

Source: BMJ | Read full story