Treatment of Neurological Manifestations of Vitamin B12 Deficiency in Malabsorption (Coeliac Disease, Partial Gastrectomy, Bariatric Surgery) without Autoimmune Gastritis
This page covers the management of neurological manifestations of vitamin B12 deficiency in the specific clinical scenario of malabsorption that is not due to autoimmune gastritis, total gastrectomy, or complete terminal ileal resection.
Clinical Scenario
This protocol applies when a person has vitamin B12 deficiency as a result of malabsorption — for example, malabsorption caused by coeliac disease, partial gastrectomy, or some forms of bariatric surgery — and where the deficiency is not caused by autoimmune gastritis, total gastrectomy, or complete terminal ileal resection.
Treatment Approach
The structured protocol addresses route-of-administration decisions for vitamin B12 in this population, including the role of intramuscular administration.
The complete algorithm — including the specific criteria, sequencing, and full clinical pathway — is available via the link below.
References
- If the person has a vitamin B12 deficiency because of malabsorption that is not caused by autoimmune gastritis, or a total gastrectomy or complete terminal ileal resection (for example, malabsorption caused by coeliac disease, partial gastrectomy or some forms of bariatric surgery):
- if they are already taking the maximum licensed dosage for oral treatment, switch to intramuscular vitamin B12 injections.
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