Treatment of Neurological Manifestations of Vitamin B12 Deficiency Due to Dietary Insufficiency
This protocol covers the management of neurological manifestations arising from suspected or confirmed vitamin B12 deficiency where the underlying cause is a diet lacking in vitamin B12.
Clinical Scenario
The person has suspected or confirmed vitamin B12 deficiency because their diet is lacking in vitamin B12, and is presenting with neurological manifestations associated with this deficiency.
Treatment Approach
Management centres on vitamin B12 replacement. The most appropriate form of replacement depends on individual clinical factors — including whether any co-existing conditions would benefit from a faster-acting route.
Treatment Goals
The aim is to increase vitamin B12 concentrations. Symptoms may begin to improve within weeks, although a full response can take longer.
References
- If the person has suspected or confirmed vitamin B12 deficiency because their diet is lacking in vitamin B12:
- consider oral vitamin B12 replacement.
- Consider intramuscular vitamin B12 injections instead of oral replacement for suspected or confirmed vitamin B12 deficiency caused by diet if: the person has another condition that may deteriorate rapidly and have a major effect on their quality of life (for example, a neurological or haematological condition such as ataxia or anaemia).
- that their symptoms could start to improve within 2 weeks, but this may take up to 3 months.
- The aim of treatment is to increase vitamin B12 concentrations.
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