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For severe cases, this process may take longer

The patient should be questioned closely about any symptoms from previous doses to prevent severe reactions

Play it safe if you: constantly feel tired despite getting enough sleep notice tingling or numbness, especially in your hands and feet are vegetarian or vegan regularly take acid blockers or metformin are over 60 years old Your doctor can determine whether you are affected with a simple blood testand advise you on the appropriate forms of therapy

The service is available to adults across Chatham, Gillingham, Rochester, Rainham, and Strood

Figure 1: B 12 Test Result Review and Process Algorithm for Patients with Risk Factor for B 12 Deficiency* and/or Non-specific** or Specific Symptom of B 12 Deficiency TOP Management Treatment In suspected B 12 deficiency, supplement both B 12 and folate