B12 switch to oral medication Following on from our practice decision to delay everyone who is currently receiving B12 injections by 3 months and offer to convert them to oral B12 during that time we have put together the following information to hopefully address any queries that patients may have.
Q – Why are you asking us to change?
A. During the current Covid 19 pandemic we are trying to reduce the footfall through the surgery as much as is safely possible. This is not only to protect you the patient from leaving home and coming down to the surgery but to also protect our staff and other patients and relatives you may come into contact with during your appointment. The NHS is under tremendous pressure at present and we are having to make some difficult decisions regarding treatments etc.
The main reasons for the change are:
• Many of patients on B12 are high risk themselves from COVID-19 and we do not want to put them at further risk bringing them down to the practice
• We are trying to protect frontline staff from unnecessary contacts and keep essential services going as well as freeing up nursing time from these appointments. As staff go off with the illness themselves this may become increasingly important as we will have limited staff available to work
Q. Does having tablets work and am I at risk if I don’t receive my injection?
A. All our patients on B12 injections will have had loading doses that are initially administered close together. Approximately 50% of the loading dose is stored in the liver for the body to use up slowly when needed and so the 3 monthly injections are just top ups. So you will have plenty of B12 from the injections you have already received to last many months through this crisis and so no you are not at risk.
Q. I have been told I don’t absorb B12 so tablets wont work for me
A. B12 is not made by the body so we have to obtain it from our diet. Usually this occurs by something called intrinsic factor which is a carrier in our body that binds to the B12 and takes in into the bloodstream. HOWEVER there is another 5% which is absorbed without the intrinsic factor. So in patients with B12 deficiency who have an issue with intrinsic factor, a small amount will be being absorbed anyway to keep the levels up. We will discuss with you prescribing high doses of oral B12 during this time (400 times the normal recommended amount) to ensure that you absorb enough to keep your levels up. There is no danger of overdose as the body will naturally dispose of excess in the urine