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This afternoon at CluB12 a fascinating overview of the history of B12 deficiency/pernicious anaemia from the amazing Ebba Nexo who has spent her whole career working in this field.

Today at CluB12. I've never really thought about how vitamin B12 is produced. Only bacteria can make it naturally, but some algae can concentrate it, hydroponics can be used to concentrate it in some plants (pea shoots). But some plants can be genetically modified to produce it (tomatoes and rice).

Today I'm in Cambridge at the CluB12 annual meeting. I've presented my journey "from patient to prescriber" in the context of vitamin B12. And I've been reminded that we can't rely on a single range for B12 blood tests. B12 levels vary enormously with age and ethnicity. We will misdiagnose people.

Symptoms of vitamin B12 deficiency are many and varied. If you want to know more, read this blog pernicious-anaemia-society.org/pernicious-a... (even this doesn't cover all of them). If you want to help your patients, read and follow the NICE guidance and this paper dx.doi.org/10.1136/bmj-...

pernicious-anaemia-society.org/research/low... I've certainly observed improvements in people's restless leg symptoms when I've corrected their B12 levels. Remembering, that unless deficiency is dietary, or the cause is correctable, long-term treatment is required, usually with injections.

Please watch: youtube.com/watch?v=PqUE...

Vitamin B12 deficiency required lifelong treatment. This fascinating article describes a case of raised B12 levels due to "macro B12" masking an underlying deficiency. casereports.bmj.com/content/15/1...