Reviewed on : 15 Jan 2024

Reviewed by : Catherine Darby

Expires : 15 Jan 2026

Primary Care Guidelines for B12 and Folate Testing

Indications for B12 and Folate Testing

No need to check B12 levels in patient on parenteral B12 treatment (they will always be high)

There is no indication to check GPA or INF purely because of family history of autoimmune disease or hypothyroidism

Care should be taken when prescribing folic acid alone – If folic acid is given to a patient who is actually b12 deficient, this may precipitate irreversible neurological complications

References

1. Devalia V, Hamilton M S , Molloy A M. (2014). ‘Guidelines for the diagnosis and treatment of cobalamin and folate disorders’. British Journal of haematology. 166 (4) 496-513.

2. Tomkins C. (2017) Guideline for Primary Care: Investigation and management of B12/folate deficiency. 30/1/17 Version2. Previously Available from: https://www.coventryrugbygpgateway.nhs.uk/pages/b12-and-folate-testing.

3. National Institute for Health and Care Excellence (2018) Diagnosis of anaemia- B12 and folate deficiency (CKS). Available at: https://cks.nice.org.uk/topics/anaemia-b12-folate-deficiency/diagnosis/. [Accessed 27th August 2020].

4. Joint Formulary Committee. British National Formulary [Internet]. London: BMJ Group and Pharmaceutical Press; Available from: www.medicinescomplete.com

5. O’Kane M, Parretti HM, Pinkney J, et al. British Obesity and Metabolic Surgery Society Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery—2020 update. Obesity Reviews. 2020;1–23. https://doi.org/10.1111/obr.13087

6. Wainwright P (2017) Q&A: Metformin and vitamin B12 deficiency. Diabetes & Primary Care 19: 63–6