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Some people have genetic alterations in their ability to process b12 that requires them to get b12 more often and in higher quantities than the average person
Vitamin B12 injections deliver their best results when they form a consistent component of a regular treatment
Benzyl alcohol works best under controlled and stable conditions
Who to refer: Patients: with symptoms suggestive of either a spinal cord lesion (subacute combined degeneration or peripheral neuropathy) or visual (optic neuropathy) same day emergency admission not responding haematologically to B12 replacement therapy (where folate and iron stores have been checked and are normal) with suspected malabsorption or disease of the terminal ileum should be referred to Gastroenterology with neurological symptoms should be discussed with Neurology if advice required
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