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Referral thresholds are broadly guided by NICE but may vary according to local NHS Integrated Care System (ICS) policies

Supplements give a lot of B12, but whole foods have more nutrients

22,23 In patients with a normal or low-normal serum vitamin B 12 level, complete blood count results demonstrating macrocytosis, or suspected clinical manifestations, a serum methylmalonic acid level is an appropriate next step 1,2,6,18 and is a more direct measure of vitamin B 12 's physiologic activity

Below are B12 deficiency signs you can look out for

You can try putting a cold compress on it for a few hours and see if it helps