Medical Injections

Treating vitamin B12 deficiency anaemia

Vitamin B12 deficiency anaemia is usually treated with injections of vitamin B12.

There are 2 types of medical vitamin B12 injections:

• hydroxocobalamin
• cyanocobalamin

Hydroxocobalamin is usually the recommended option as it stays in the body for longer.

At first, you’ll have these injections every other day for 2 weeks or until your symptoms have started improving.

After this initial period, your treatment will depend on whether the cause of your vitamin B12 deficiency is related to your diet or whether the deficiency is causing any neurological problems, such as problems with thinking, memory and behaviour.

The most common cause of vitamin B12 deficiency in the UK is pernicious anaemia, which is not related to your diet.

Diet-related

You may need to have an injection of hydroxocobalamin twice a year.

Good sources of vitamin B12 include:

• meat
• salmon and cod
• milk and other dairy products
• eggs

If you’re are looking for alternatives to meat and dairy products, there are other foods that contain vitamin B12, such as yeast extract (including Marmite), as well as some fortified breakfast cereals and soy products.

Check the nutrition labels while food shopping to see how much vitamin B12 different foods contain.

Not diet-related

If your vitamin B12 deficiency is not caused by a lack of vitamin B12 in your diet, you’ll usually need to have an injection of hydroxocobalamin every 2 to 3 months for the rest of your life.

If you have had neurological symptoms that affect your nervous system, such as numbness or tingling in your hands and feet, caused by a vitamin B12 deficiency, you’ll be referred to a haematologist and may need to have injections every 2 months.

Your haematologist will advise on how long you need to keep taking the injections.

For injections of vitamin B12 given in the UK, hydroxocobalamin is preferred to an alternative called cyanocobalamin. This is because hydroxocobalamin stays in the body for longer.

If you need regular injections of vitamin B12, cyanocobalamin would need to be given once a month, whereas hydroxocobalamin can be given every 3 months.

Cyanocobalamin injections are not routinely available on the NHS as hydroxocobalamin is the preferred treatment.

But if you need replacement tablets of vitamin B12, these will usually be in the form of cyanocobalamin.

Treating folate deficiency anaemia

To treat folate deficiency anaemia, your GP will usually prescribe daily folic acid tablets to build up your folate levels.

They may also give you dietary advice so you can increase your folate intake.

Good sources of folate include:

• broccoli
• brussels sprouts
• asparagus
• peas
• chickpeas
• brown rice

Most people need to take folic acid tablets for about 4 months. But if the underlying cause of your folate deficiency anaemia continues, you may have to take folic acid tablets for longer, possibly for life.

Before you start taking folic acid, your GP will check your vitamin B12 levels to make sure they’re normal.

This is because folic acid treatment can sometimes improve your symptoms so much that it masks an underlying vitamin B12 deficiency.