Pernicious anaemia treatment during COVID-19
Articles & Resources
Guidelines on Pernicious Anaemia during COVID-19
How should my management of vitamin B12 deficiency vary when considering the possibility of COVID-19?
Non-dietary vitamin B12 deficiency
Discuss the need for intramuscular (IM) hydroxocobalamin with each person.
Ask people who require IM hydroxocobalamin COVID-19 screening questions before they attend GP surgeries.
Explore alternatives to attending GP surgeries for administration, such as local pharmacies or home administration by district nurses.
Offer oral cyancobalamin 1 mg per day as an alternative until regular IM hydroxocobalamin can be resumed — aim for the shortest possible break from regular injections.
Advise people to monitor their symptoms and contact their GP if they begin to experience neurological or neuropsychiatric symptoms, such as pins and needles, numbness, problems with memory or concentration, or irritability.
People who are already self-administering IM hydroxocobalamin should continue to do so.
Switching to self-administration during the COVID-19 pandemic is not recommended as instruction is likely to be difficult.
BSH guidance on B12 supplements during COVID pandemic
Non-dietary vitamin B12 deficiency
(e.g. pernicious anaemia, prior gastrectomy, bariatric surgery, achlorhydria, pancreatic insufficiency, short bowel syndrome, bacterial overgrowth, inflammatory bowel disease)
NICE Clinical Knowledge Summary 2019: administer hydroxocobalamin 1 mg intramuscularly every 2–3 months for life
British Society for Haematology advice during the COVID-19 pandemic for patients
established on intramuscular hydroxocobalamin:
The need for intramuscular (IM) hydroxocobalamin should be discussed with each patient individually. We recommend that screening questions for COVID-19 infection are asked before patients attend their GP surgeries. Alternatives to attending the GP surgery such as local pharmacies or home administration by district nurses should be explored.
As an alternative, oral cyanocobalamin can be offered at a dose of 1 mg per day until regular IM hydroxocobalamin can be resumed, i.e. once GP surgeries are able to do so safely, aiming to have a shortest possible break from regular injections.
Patients should be advised to monitor their symptoms and should contact their GP if they begin to experience neurological or neuropsychiatric symptoms such as pins and needles, numbness, problem with memory or concentration or irritability.
Patients who are already self-administering IM hydroxocobalamin should continue to do so but we do not recommend a patient switching to self-administration during the COVID-19 pandemic since instruction is likely to be difficult
Articles about Pernicious Anaemia during COVID-19
News articles about Pernicious Anaemia during COVID-19
The James Lind Alliance Pernicious Anaemia Priority Setting Partnership, Steering Group and the survey - What's it all about? In recent weeks we’ve been asking you to complete our James Lind Alliance Pernicious Anaemia Priority Setting Partnership Survey. Now, that’s...
When the pandemic led to changes in patients’ treatment, we became aware that far too many patients were suffering harm because either their treatment was stopped, or they were told to find an alternative way to treat themselves. Despite ongoing research, there are...
Last Updated: 21 February 2021: You may remember that last month we wrote to the Chief Medical Officers in the UK to point out that the symptoms of Long-Covid were remarkably similar to those of Vitamin B12 Deficiency and that..
General information about Pernicious Anaemia
For people with no neurological involvement: Initially administer hydroxocobalamin 1 mg intramuscularly three times a week for 2 weeks. Maintenance dose: hydroxocobalamin 1 mg intramuscularly every 2–3 months for life.