Neurological manifestations of vitamin B12 deficiency
ICD-10 D51.9 ICD-11 8A45.30

Treatment of Neurological Manifestations of Vitamin B12 Deficiency When the Cause Is Uncertain

Clinical Scenario

This protocol applies to neurological manifestations of vitamin B12 deficiency in people where the underlying cause of the deficiency is uncertain — and where malabsorption has not been identified as the mechanism based on further testing or investigations.

Treatment Approach

Vitamin B12 replacement is indicated in this setting. The protocol addresses which route of administration to consider — the full structured regimen specifies the decision points and follow-up requirements beyond what can be summarised here.

Treatment Goals

The aim of treatment is to increase vitamin B12 concentrations. Symptoms could start to improve within 2 weeks, though full recovery may take up to 3 months.

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References

In people with a vitamin B12 deficiency where the cause is uncertain, and malabsorption is not suspected based on the results of further testing or investigations:

Offer vitamin B12 replacement and consider oral instead of intramuscular vitamin B12 replacement and review response to treatment at the person's first follow-up appointment.

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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