B12 NICE Guidelines: 2024 update

What are the NICE Guidelines?

The NICE guidelines are recommendations based on scientific evidence for the treatment of different medical conditions. The National Institute for Health and Care Excellence (NICE) are built from the most reliable evidence at hand, with recommendations created by a panel of experts, utilising services, caregivers, and members of the public.

The NICE Guidelines set out directives to help GPs and healthcare professionals deliver treatment and arrange referrals. Not adhering to these directives could lead to mistreatment or misdiagnosis, potentially causing harm to the patient. This situation could be especially significant in cases of B12 deficiency.

What updates were made to the NICE Guidelines in 2024?

The updated NICE guidelines recommend GPs to consider the possibility of vitamin B12 deficiency in patients exhibiting one symptom or one risk factor. It emphasises the importance of recognising a wide range of symptoms and signs that could indicate a deficiency - including cognitive difficulties, such as:

• Eyesight problems
• Mental health issues
• Neurological/mobility problems
• Unexplained fatigue

The NICE guidelines for B12 deficiency highlight the necessity for an initial diagnostic, utilising either total B12 or active B12 tests, (unless specific circumstances require an alternative approach). The NICE guidelines for B12 deficiency stress the significance of not ruling out a diagnosis based solely on the absence of certain indicators like anaemia or macrocytosis.

Additionally, the guidelines urge healthcare professionals to be aware of common risk factors associated with B12 deficiency, such as:

• Age
• Dietary restrictions
• Family history
• Certain health conditions
• Medication use
• Previous surgeries

The focus on recognising risk factors prompts earlier testing and diagnosis, aiming to prevent delays in treatment that could lead to severe consequences for patients, as seen in both our clients’, Jimmy Norman and Charlotte Heywood’s case.

These guidelines offer a comprehensive approach to diagnosing and managing vitamin B12 deficiency, urging healthcare professionals to consider the broader spectrum of symptoms and risk factors in patient assessment.

What are the symptoms of a B12 deficiency?

Vitamin B12 is an essential nutrient that is involved in the production of red blood cells. Red blood cells maintain nerve health and support DNA formation in the human body. A B12 deficiency is not something normally of concern to most people until they start to notice symptoms such as those listed above. Following NICE guidelines, a B12 deficiency is easily treatable.

Insufficient levels of vitamin B12 within the body may lead to a range of symptoms, including:

• Quickened breathing or breathlessness
• Headaches
• Palpitations
• Vision issues
• Weakness or fatigue
• A sore or reddened tongue, occasionally accompanied by mouth ulcers
• Challenges related to memory, comprehension, and decision-making (cognitive alterations)
• Numbness
• Muscle weakness
• Difficulties with coordination and balance

What happens when B12 deficiency is misdiagnosed or treatment is delayed?

Nerve damage in eyes and spine

In the case of Charlotte Heywood, a delayed diagnosis resulted in devastating, irreversible effects affecting her mobility and vision. Despite initial treatment, Charlotte's condition worsened, leading to severe symptoms such as exhaustion, debilitating leg pain, and dramatic weight loss.

After repeated doctor visits, a routine appointment flagged alarming changes, prompting urgent neurology referrals. Despite initial scepticism, testing confirmed Charlotte's B12 deficiency, revealing irreversible damage to her spinal and optic nerves. While she now receives B12 treatment, the delay caused lasting impairments, including difficulty walking due to severe numbness and impaired vision.

Severe and persistent fatigue

Jimmy Norman's battle with vitamin B12 deficiency also serves as a cautionary tale about devastating consequences. Unfortunately, recognising symptoms gradually worsening, Jimmy faced reluctance from healthcare professionals to administer timely and appropriate treatment.

His struggle began with persistent fatigue, tingling sensations, and a decline in health, forcing him to pause his career and daily activities. Despite a family history of B12 deficiency, Jimmy's deteriorating condition didn't prompt immediate action due to inconclusive blood test results. This further delayed crucial injections prescribed by the NICE guidelines.

The deficiency had a profound impact on his life, his worsening condition had forced him onto sick leave and disrupted a considerable amount of his charitable work. Watching Charlotte’s story shed light on the impact of a vitamin B12 deficiency, leading Jimmy to seek our legal assistance.

Getting help for B12 deficiency misdiagnosis

Fortunately, both individuals found support from our expert medical negligence team. These cases highlight Slater and Gordon's commitment to complex medical negligence cases, advocating for clients' rights and striving to prevent misdiagnosis and mistreatment.

Our team of medical negligence specialists have won awards year after year for their legal excellence and are recognised as leaders in the field, both in the prestigious Chambers and Partners guide and in the Legal 500.

Simply call us today on 0330 107 5060, or contact our medical negligence team.