The video version of this podcast can be found here: https://youtu.be/0cD2zityw9I The interactive flowchart can be accessed here: https://1drv.ms/b/s!AiVFJ_Uoigq0mRYQ2Yw67rtg00TM?e=2DpSYI This episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE. My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I will go through the recently published NICE guideline on vitamin B12 deficiency in adults, focusing on those that are relevant to Primary Care only.   I am not giving medical advice; this video is intended for health care professionals; it is only my summary and my interpretation of the guidelines and you must use your clinical judgement.     There is a podcast version of this and other videos that you can access here:   Primary Care guidelines podcast:   ·      Apple podcast: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 ·      Spotify: https://open.spotify.com/show/2kmGZkt1ssZ9Ei8n8mMaE0?si=9d30d1993449494e ·      Amazon Music: https://music.amazon.co.uk/podcasts/0edb5fd8-affb-4c5a-9a6d-6962c1b7f0a1/primary-care-guidelines?ref=dm_sh_NnjF2h4UuQxyX0X3Lb3WQtR5P ·      Google Podcast: https://www.google.com/podcasts?feed=aHR0cHM6Ly9mZWVkcy5yZWRjaXJjbGUuY29tLzI1ODdhZDc4LTc3MzAtNDhmNi04OTRlLWYxZjQxNzhlMzdjMw%3D%3D ·      Redcircle: https://redcircle.com/shows/2587ad78-7730-48f6-894e-f1f4178e37c3 There is a YouTube version of this and other videos that you can access here:  The Practical GP YouTube Channel:  https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The NICE guideline “Vitamin B12 deficiency in over 16s: diagnosis and management” (NICE guideline NG239 can be found here: ·      https://www.nice.org.uk/guidance/ng239 The links to the resource “Oral vitamin B12 replacement: ongoing care and follow up” can be found here: ·      https://www.nice.org.uk/guidance/ng239/resources/visual-summary-ongoing-care-and-followup-for-vitamin-b12-replacement-pdf-13315996909 The B12 pandemic guidance by the British Society of Haematology can be found here: ·       https://apps.nhslothian.scot/refhelp/guidelines/haematology/b12deficiency/ Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release]  Music provided by Audio Library Plus  Watch: https://youtu.be/aBGk6aJM3IU  Free Download / Stream: https://alplus.io/halfway-through    Transcript If you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description. Hello and welcome, I am Fernando, a GP in the UK. Today, we are looking at the NICE guideline on vitamin B12 deficiency in adults, published as recently as March 2024, focusing on what is relevant in Primary Care only. Make sure to stay for the entire episode because, at the end, I will tell you how to access an interactive flowchart that I have created and that summarises the guidance. Right, so let’s jump into it.   Let’s start by looking at common symptoms and signs of vitamin B12 deficiency, which are: ·      anaemia or macrocytosis on a FBC, but we should not rule out a diagnosis of vitamin B12 deficiency based solely on the absence of either anaemia or macrocytosis ·      difficulty concentrating or short-term memory loss, also sometimes described as 'brain fog' ·      glossitis and mouth ulcers ·      unexplained fatigue ·      eyesight problems related to optic nerve dysfunction like o  blurred vision o  a visual field loss or scotoma and o  optic atrophy signs on fundoscopy ·      neurological or mobility problems inclu