B12 and GP

[midnightblue12]

Ok so I had some bloods done a couple weeks ago after just generally feeling unwell and low for a while.
All normal but b12 is low. Apparently normal (or the NHS seem normal!!) is anything over 200, mine is 180.
The gp asked me to get OTC b12 supplements for 3 months.
Absolutely fine and happy to do this. No big deal, was looking forward to trying it and feeling brighter!
Anyway as I'm breast feeding the pharmacist said I cannot purchase b-2 OTC as the dose is too high. Pharmacist told me to go back to the go and request a prescription.
I did that and the go text me saying
"Your results are only slightly lower so whenever you stop breast feeding you can pick up the OTC supplements".

I am really shocked by this. I cannot understand how I'm being told one day to go and buy suppliements due to my results and the next I'm being told it doesn't matter. Seemingly GP recommends I take supplements when I have to pay but on perscription it's a no.

I get my results aren't drastically low, but they are still outside of the Normal bracket.

Go have also never even spoke to me to understand where I'm at with my bf journey.

Anyone else think this is a bit of a shrug off?

My mym has very low b12. She's been having injections via the go for years. She got a call this week saying they were stopping this and she needs to buy OTC. She has a heart condition and had cancer in the past so she's very vulnerable. Seems like they're pushing not wanting to perscribe b12!

I'd take it more as being exactly what they said to be honest. You are only slightly low. You're not needing a strong prescription or anything. So it should be OK to wait until its safe to take what they recommended.

Get mine OTC. GP friend said women over 50 should all take It but they can't prescribe it.

Surprised the pharmacist did not just advise you to buy a lower dose. You can have vitamin b12 while breastfeeding - it is in supplements which are specifically for women who are breastfeeding. Could you not just buy some of those?

Sounds like a sensible plan really.

The 'normal' levels are a guideline not a rule. They tend to be defined around what would the average levels which have been found in a middle aged white European man. If the GP feels your levels are sufficient in conjunction with their assessment/exam findings then that's good.

In regards to prescribing OTC drugs, there's a huge pressure to stop and reduce NHS expenditure on medications. As an example every year the NHS spends about £100 million on paracetamol. There's probably better ways that money could be used (not discounting paracetamol, it's a wonderful drug and pretty much the only thing I ever issue when working as a Paramedic).

You could up your intake of B12 in your diet. I say this as someone who has regular b12 injections as I can not absorb it from my diet but I do still try to eat enough.

If you can not absorb it from diet (so have pernicious anaemia), then all the meat and veg in the world will not get your levels up.

The supplements are easy to buy and it's simple enough to increase the dietary intake as well. I'm on the injections as well and the threshold here is under 140 then it's reviewed at 12 months and you are either on them for life or taken off them and told to go onto supplements. Unfortunately my levels got so low I'm on the injections for life.

I really recommend getting on them sooner rather than later and up your dietary intake too. When my levels were at their lowest I lost all coordination - I remember one instance I went to walk forwards but my legs went backwards instead!!

Until the OP has the specific test for PA she doesn't know if that is the cause or not, so advising to up dietary sources is good advice.

I buy mine from H&B or the like. I used to get a B12 injection as well every now and again (£25) but the local lady stopped doing them.

I can’t comment specifically on your case compared to mine as I’m not breastfeeding, but I was recently diagnosed as being deficient in B12, vitamin D and folate.

Ive had one B12 injection at the drs and then told to buy supplements so I bought a spray from Holland and Barrett.

Im on a high dose of vitamin D once a week for 6 weeks and start my folic acid in 2 weeks.

I can understand how you felt as I was fatigued, down, had memory issues but I’m feeling much brighter now.

Hope you can get sorted soon.

You can pay for vitamin B12 injections privately, I would advise doing this based on your levels

Here's a good guide exploring a bit more in regards to B12 levels and when to start treatment:

www.gloshospitals.nhs.uk/our-services/services-we-offer/pathology/tests-and-investigations/vitamin-b12-and-serum-folate/

"Patients with B12 in the borderline range (150 - 180 pg/ml) may have either early B12 deficiency or be healthy "low normal"."

They suggest considering a trial of B12 replacement, with the alternative being just to repeat the test no sooner than 3 months.

Guys like I said in my OP, I have no problem buying the tablets, but as I'm BF they do not sell the recommended dose OTC and can only be bought on perscription.
I've not been feeling well and have been down for a while. I might only be just below the bracket (which is the NHS bracket) but I'm still low.
I don't see why they would recommend I buy it but when I need a perscription it's a no.

Because you do not currently meet the required level for a prescription presumably.

You don't actually know that your slightly low B12 levels are the cause of how you feel.

I would do as others suggest, take a general BF vitamin supplement now & eat a healthy diet with B12 in mind.

Is it not possible to buy them in a lower dose OP?

Like PP’s have said because you’re not classed as deficient they won’t prescribe & are notorious for cutting g costs where possible & acting like they couldn’t give a shit about your health - when basic nutrition is absolutely paramount to general health & well-being.

You will have more luck getting a lower dose & supplementing yourself.

Why can't you go to another chemist and not tell them you're breastfeeding?

@XenoBitch yes I have PA but I still enjoy eating B12 rich foodstuffs. I’m married to a vegetarian so a good steak is something of a rarity but it doesn’t stop me enjoying it. It does me no harm to eat these foods.
my advice was to op, as she may just be low in B12 rather than having PA. But thank you for your concern, my ailment was fully explained to me by my doctor and it runs in my family. Glad to see your medical degree wasn’t wasted.

@carriedout maybe not but I had blood tests because of how I feel and that was what came back low so it's be ridiculous to ignore it.

I'm just worried about to not being safe

Just order them online? Or buy a breastfeeding multivitamin until you stop. No big deal.

Thank you, I agree with what you've said.
If the go are happy for me to buy it (which I'm also happy to do) but then it transpires that I need a perscription all of a sudden it's ok for me just to wait 😵‍💫

I would look into getting a b12 injection privately. Nhs website says they are safe whilst breast feeding.

Nhs levels are minimum not optimal. Worth trying to see if it helps how you are feeling

I've said a few times the pharmacy has said you can't buy the safe dose Without a perscription.
I asked about the multivitamin and she said that the b12 is much lower then what I could get on perscription.
It might not be a big deal to you, but it is important to me so please don't come on my thread and try and invalidate what's important to me.

Then make a gp appointment?

If it was me, I'd read up on any relevant NICE guidance first.

I don't think this is a massive thing, personally, so I would just take a BF supplement and see if that helped..

I think you are right, you should not purchase against medical advice.