Treating Pernicious Anaemia – Basic

It wasn’t until the 1920’s that any treatment was available for Pernicious Anaemia. A team of doctors in the USA found that giving patients large amounts of (preferably raw) liver meant that the patient could at least be kept alive. Until ‘artificial’ B12 was produced in the 1950’s patients relied on liver therapy (liver injections were made available in the 1940’s) to keep themselves alive. With the new B12 injections the patients would be able to live a normal life.

Unfortunately, we now know that some patients will still experience to some extent or other, the symptoms of B12 deficiency though nobody has been able to explain this.

And there’s one other fact that the Pernicious Anaemia Society is aware of: some patients need more frequent injections than others. Currently, most healthcare providers, including the NHS in the UK, will prescribe a ‘one-size-fits-all’ treatment regimen. In the UK this is one injection of 1mg/ml Hydroxocobalamin once every twelve weeks. This used to be prescribed every month in the 1960’s but this was changed by the British National Formulary to every two months in 1974 and then to every three months in 1984. The frequency of injections is the biggest cause of complaint by members of the Pernicious Anaemia Society and when the doctor refuses to depart from the recommendations of the BNF the patient has to suffer needlessly until their next injection is due. Some patients need injections every two weeks while others can manage eight weeks before their symptoms return. Good physicians will listen to their patients and prescribe a treatment regime based on their patient’s need rather than on the advice of the BNF, and in many cases this does happen. Often it is not the patient who notices the symptoms returning but it is picked up by family members of work colleagues who notice a change of behaviour or poor workplace performance.

When doctors refuse to prescribe more frequent injections the patient is then forced to seek alternative treatments often without the consent or knowledge of their doctor.

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