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How to Treat Vitamin B12 Deficiency?

Medical Treatment:
  • In general, vitamin B12 deficiency anemia is treated with vitamin B12 injections in a form called hydroxocobalamin.
  • You will have these injections for two weeks every other day at first, or until your symptoms begin to improve. The injections will be given by your GP or nurse.
  • Your treatment will depend on whether the cause of your deficiency of vitamin B12 is related to your diet after this initial period. The UKs most common cause of vitamin B12 deficiency is pernicious anemia that is not associated with your diet.
  • If your vitamin B12 deficiency is caused by a lack of vitamin in your diet, vitamin B12 tablets may be prescribed to take between meals on a daily basis. Alternatively, hydroxocobalamin may need to be injected twice a year.
  • People who find it hard to get enough vitamin B12 in their diets, like those following a vegan diet, may need life - long tablets of vitamin B12.
  • Although it is less common, people with vitamin B12 deficiency caused by a prolonged poor diet may be advised to stop taking the tablets once their levels of vitamin B12 have returned to normal and their diet has improved.
  • Good sources of vitamin B12 include:
    • Meat
    • Salmon and cod
    • Milk and other dairy products
    • Eggs
  • If you are a vegetarian or vegan or are looking for alternatives to meat and dairy products, there are other foods that contain vitamin B12, such as yeast extract (including Marmite), as well as some fortified breakfast cereals and soy products.
Not diet-related
  • If your vitamin B12 deficiency is not caused by a lack of vitamin B12 in your diet, you will usually need to have a hydroxocobalamin injection every three months for the rest of your life.
  • If you have neurological symptoms (symptoms affecting your nervous systems, such as numbness or tingling in your hands and feet) caused by a deficiency of vitamin B12, you will be referred to a hematologist and you may need to have injections every two months. Your hematologist will advise how long you will need to continue taking the injections.
  • Hydroxocobalamin is preferred to an alternative called cyanocobalamin for injections of vitamin B12 in the UK. This is because, for longer, hydroxocobalamin remains in the body.
  • If you need regular injections of vitamin B12, cyanocobalamin would need to be given once a month, whereas hydroxocobalamin can be given every three months.
  • Injections of cyanocobalamin are not routinely available on the NHS. If you need vitamin B12 substitute tablets, however, these will be cyanocobalamin.
Treating folate deficiency anemia
  • Usually, your GP will prescribe daily folic acid tablets to build up your folate levels to treat folate deficiency anemia. They can also give you nutritional advice to increase your intake of folate.
  • Good sources of folate include:
    • Broccoli
    • Brussels sprouts
    • Asparagus
    • Peas
    • Chickpeas
    • Brown rice
  • For about four months, most people need to take folic acid tablets. However, if your folate deficiency anemia continues to be the underlying cause, you may need to take folic acid tablets for longer-possibly for life.
  • Your GP will check your vitamin B12 levels to make sure they are normal before you start taking folic acid. This is because folic acid treatment can sometimes improve your symptoms so much that it masks an underlying vitamin B12 deficiency.
  • If there is no detection and treatment of a vitamin B12 deficiency, it may affect your nervous system.