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Your doctor will conduct a comprehensive clinical assessment including: Detailed medication and supplement history , including over-the-counter vitamins and injections Review of symptoms suggesting liver, kidney, or haematological disease Physical examination for hepatomegaly, splenomegaly, jaundice, or lymphadenopathy Additional blood tests , such as full blood count, liver function tests, renal function, and inflammatory markers Depending on initial findings, further investigations may include: Liver ultrasound or imaging if hepatic pathology is suspected Haematology referral for blood film examination, bone marrow biopsy, or specific tests for myeloproliferative disorders Measurement of holotranscobalamin or methylmalonic acid if functional B12 status needs clarification despite high total B12 Targeted investigations based on clinical findings and following NICE guidance for suspected serious conditions Treatment focuses on addressing the underlying cause rather than the elevated B12 itself

Most of us are in a state of panic at the moment, but imagine having anxiety levels through the roof and then being told you cant have your life-saving medication for six months because someone ignorant of your condition has decided that YOU dont matter

How do international prescribing practices for B12 injections vary

If the issue lies with absorption, B12 shots or IV infusions are an effective alternative to oral supplements because they are administered via injection or intravenously, meaning they do not need to be absorbed through the digestive process

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