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.
https://cks.nice.org.uk/anaemia-b12-and-folate-deficiency#!scenarioRecommendation:4
https://cks.nice.org.uk/coronavirus-covid-19#!scenario:1

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
https://b-s-h.org.uk/media/18275/bsh-guidance-b12-replacement-covid-1901052020finalv.pdf
Articles about Pernicious Anaemia during COVID-19
Managing Pernicious Anaemia in the time of Corononavirus
Treating Pernicious Anaemia during COVID-19 - a guide for doctors
Reflections on Treating Pernicious Anaemia
News articles about Pernicious Anaemia during COVID-19
Long COVID and Pernicious Anaemia
Symptoms of B12 DeficiencyRemember back in the day when you had the symptoms of B12 Deficiency due to Pernicious Anaemia. And some of you won’t have to remember because you still suffer from the symptoms to some degree or other even though you are (hopefully) being...
Treatment concerns during COVID-19? Let NHSE know
So, the clocks went back an hour last week, which means, we suppose, that we get an extra hour of 2020; another hour on a year that has been like no other than we can remember. For far too many patients who have Pernicious Anaemia the Covid-19 pandemic has brought...
Guideline on Pernicious Anaemia commissioned by NICE
After four years of working with the National Institute for Health and Care Excellence (NICE) we are delighted to announce that a Guideline on the Diagnosis and Maintenance of Pernicious Anaemia was commissioned by the institution in August of this year. This is a...
General information about Pernicious Anaemia
Testing B12 during treatment
NICE Management of anaemia - vitamin B12 and folate deficiency
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.
https://cks.nice.org.uk/anaemia-b12-and-folate-deficiency#!scenario