Case Scenario 

Romika, in her mid-20s, asks your advice about ongoing fatigue and pins and needles which she has had for several months. You recognise that her strict vegan diet increases her risk of vitamin B12 deficiency and that her symptoms are consistent with this. You refer her to her GP for blood tests. There is macrocytosis and her serum B12 level is equivocal. Her HoloTC levels are found to be 35 nmol/L, indicating likely B12 deficiency.

Learning Objectives 

After reading this article, pharmacists should be able to: 

  • Describe the causes of vitamin B12 deficiency 
  • Discuss how vitamin B12 deficiency is diagnosed 
  • Describe the treatments for vitamin B12 deficiency 
  • Discuss when pharmacist administration of intramuscular vitamin B12 is appropriate. 

Competency (2016) standards addressed: 1.1, 1.4, 1.5, 2.2, 3.1, 3.2, 3.5

 

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Introduction 

Vitamin B12 (cobalamin) is an essential water-soluble vitamin that humans obtain from their diet.1-6 Deficiency can cause serious haematological, neurological and psychiatric problems.1-6 Early diagnosis and treatment may reverse defici

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