Volume packages (48 injections) often reduce per-unit cost by 1525%
Causes Dietary deficiency strict vegetarian or vegan diet Pernicious anemia autoimmune destruction of stomach cells that absorb B12 Malabsorption disorders celiac disease, Crohns disease, atrophic gastritis Medications long-term use of proton pump inhibitors, metformin Surgical removal of stomach or intestines reduces absorption Signs and Symptoms Fatigue and weakness Pale or jaundiced skin Tingling or numbness in hands and feet (neuropathy) Difficulty walking or balance problems Memory loss, confusion, or mood changes Glossitis swollen, red tongue Shortness of breath, dizziness Complications (if untreated) Permanent nerve damage tingling, numbness, or difficulty walking Megaloblastic anemia large, immature red blood cells Cognitive decline or dementia in severe cases Diagnosis Blood tests low B12 levels, high homocysteine and methylmalonic acid Complete blood count (CBC) shows anemia Intrinsic factor antibodies if pernicious anemia is suspected Treatment Vitamin B12 supplementation: Oral B12 tablets for mild deficiency Intramuscular B12 injections for severe deficiency or absorption problems Dietary sources: Meat, fish, poultry, eggs, dairy products Fortified cereals or plant-based milk for vegetarians Vitamin B12 deficiency can cause anemia and nerve damage
A supplementary consultation event with school children is planned to take place in Bearsden Academy in November 2025 The Land Planning Policy Team has prepared and submitted a response to the Scottish Governments consultation on draft guidance on Planning Obligations and Good Neighbourhood Agreements
Occasionally patients may stop treatment and remain euthyroid
