Romika, in her mid-20s, asks your advice about ongoing fatigue and pins and needles which she has had for several months. You recognise that her strict vegan diet increases her risk of vitamin B12 deficiency and that her symptoms are consistent with this. You refer her to her GP for blood tests. There is macrocytosis and her serum B12 level is equivocal. Her HoloTC levels are found to be 35 nmol/L, indicating likely B12 deficiency.
After reading this article, pharmacists should be able to:
Competency (2016) standards addressed: 1.1, 1.4, 1.5, 2.2, 3.1, 3.2, 3.5
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Vitamin B12 (cobalamin) is an essential water-soluble vitamin that humans obtain from their diet.1-6 Deficiency can cause serious haematological, neurological and psychiatric problems.1-6 Early diagnosis and treatment may reverse defici
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