Vitamin B12 deficiency

The clinician should ensure that the patient is followed up as clinically indicated because some patients may not have complete resolution of neurological symptoms, despite adequate treatment. It should be explained that treatment may only prevent further neuropsychiatric complications.

Patients should be advised about the importance of eating animal-derived foods, such as fish, meat, eggs, and milk, or taking multivitamin supplements.[58]National Institutes of Health, Office of Dietary Supplements. Dietary supplement fact sheet: vitamin B12. 2022 [internet publication]. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional

Specific advice for patients on plant-based diets (including vegans and strict vegetarians) includes taking a daily vitamin B12 supplement with food and choosing food products that are labelled as being fortified with vitamin B12.[111]Niklewicz A, Smith AD, Smith A, et al. The importance of vitamin B(12) for individuals choosing plant-based diets. Eur J Nutr. 2023 Apr;62(3):1551-9. https://www.doi.org/10.1007/s00394-022-03025-4 http://www.ncbi.nlm.nih.gov/pubmed/36469110?tool=bestpractice.com