Overview

NICE (2024) Vitamin B12 deficiency can cause a wide range of symptoms and complications, including physical and mental health problems, neurological problems and cognitive impairment. It is more common in older people but can occur at any age for many reasons such as dietary deficiency, problems with absorption, various medications and use of nitrous oxide.

The course will adhere to guidance from NICE (2024) which aims to improve the diagnosis and management of vitamin B12 deficiency, in order to reduce complications and improve quality of life for people with suspected or confirmed vitamin B12 deficiency.

Content

• Signs, symptoms and common risk factors
• Diagnostic tests and investigations to identify common reversible and irreversible causes of proven vitamin B12 deficiency including:
• Types of gastrointestinal surgery
• Autoimmune gastritis and pernicious anaemia
• Malignancy
• Dietary
• Medication induced
• Nitrous oxide induced
• Unknown cause
• Management including:
• Intramuscular vitamin B12
• Oral vitamin B12 replacement
• Dietary vitamin B12 supplementation
• Diet
• Medication review and optimisation
• Advice re nitrous oxide use
• Contraindications, precautions, adverse drug reactions, risk of anaphylaxis
• Injection technique, infection control, storage and disposal of B12 products and injection paraphernalia
• Monitoring, follow up and ongoing care including health promotion and support
• Legal and professional accountability including:
• Principles associated with policies, procedures, protocols and clinic/session/appointment management
• Supervised practice, competence and indemnity
• Prescribing and authorisation to administer eg PSDs
• Informed consent
• Record keeping

Aims & Outcomes

• To facilitate diagnosis and management of people with vitamin B12 deficiency from age 16 years
• To be able to provide accurate, evidence based information about vitamin B12 deficiency
• To be able to explain about tests, investigations and treatments for vitamin B12 deficiency
• To provide a safe, effective and high standard of care