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Unfortunately the letter below is typical of those sent out to B12 deficient patients, full of incorrect information.
letter Y
This shockingly ignorant doctor, who has spent a fair old time at medical school still hasn’t grasped the basics. He states that ‘The blood tests that we have taken to work out why you had a low B12 have shown that the B12 has come back up to normal as has the folic acid. Therefore you can stop both of these.’
The doctor came to this bizarre conclusion even though the the patient was given a B12 injection 2 days before the blood was taken for the tests. This means that OBVIOUSLY it will show a much higher level of B12 than the patient had upon diagnosis. The doctor sadly doesn’t consider that this is a foolish statement and forgets that his patient will require injections for life.
It is all very simple in his world.
He goes on to say that ‘ …..there is a possibility that the low B12 was possibly caused by coeliac disease…..’
And so in his mind, the patients B12 deficiency is now miraculously cured. This would of course be akin to pumping up a punctured tyre and declaring it fixed.
B12 serum levels mean just about nothing once a patient is undergoing treatment with B12 injections. It is pointless to continually waste NHS funds to keep re checking B12 levels of a deficient patient just so that it can be used as an excuse to stop injections that the patient desperately needs.  It would however be appropriate to check once in a new patient to see if they are responding to B12 injections but this is all that’s required.
This doctor correctly identifies the fact that the body may not be able to absorb ‘certain nutrients’ if they have coeliac disease but totally misses the point that the patient has autoimmune pernicious anaemia and it won’t go away just because the doctor has found another autoimmune condition.
Autoimmune conditions like to keep each other company in certain patients.
The doctor kindly states that if the patient has any questions to contact him –
Pertinent questions for him might be;
• When are you going to reinstate the patient’s urgent injections?
• Will you treat the patient as per NICE and BNF Guidelines?
• Will you check the patient for other nutrient deficiencies and treat them properly?
And finally – During your medical training, how much time was spent on the complexities of B12 deficiency and  pernicious anaemia?
Best wishes, Tracey
If you think you may be deficient please visit the What to do next page.
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