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 would be bloody putting in a complaint with the doctors. You can’t say to a breastfeeding mum when ever you stop breastfeeding, no wonder our levels are so bloody low in this country.

How about the doctors support you and understand your breastfeeding journey, maybe you were planning on stopping soon or maybe you wanted to hit a certain milestone.

They should be providing an alternative while you breastfeed not encouraging you to stop breastfeeding.

Not saying they need to give you a prescription at all but saying they should be supporting you, say this dose is completely safe or this an alternative etc etc

In this circumstance, I would buy the lower, safe for breastfeeding, dose that you get in general multivitamins just now, until you are no longer breastfeeding.

It's likely that the higher dose is only considered not safe because it has not been tested - excess b12 gets eliminated easily by the body - but I understand your concern over it. But the lower doses can make a difference - not as quickly, but as you are not very low, that's ok.

B12 is a hot topic in my surgery. They’ve been moving patients on B12 injections onto tablets over time. Patients with diagnosed Pernicious Anemia who have to have it intravenously because their gut can’t absorb the tablets. It’s a disgrace & backed by the lead GP for the practice.
If untreated/undiagnosed PA can have serious consequences. And less than optimal B12 in anyone will have health consequences. GP’s are Ime terrible when it comes to treating & managing vitamin deficiencies in general.

I’m more annoyed that the pharmacist didn’t feel competent enough to give you what must be quite basic advice.

Ask your gp to test you for anti parietal cell antibodies and intrinsic factor before you start the b12 as results aren't accurate when you are on it. Worth knowing that they are negative in 40% of people who actually do have pernicious anemia
They stopped my injections years ago saying it was probably pregnancy that made it low and stopped checking because of covid and not wanting anyone in the practice. After being back and forth for the past 2 years and continuous prescribed tablets not bringing my levels up I've finally got injections back. Just completed the loading doses and already noticed a difference

If you feel that unwell why don't you stop breastfeeding and take the supplements?

Low b12 and pernicious anaemia can actually be extremely dangerous and remember that the nhs has different levels which they consider normal or slightly low might be excessively low or deficient in other countries.

The fact that you are feeling awful is a sign you are having symptoms so need treatment and the people on here telling you to wait until you arent bf probably dont know how you feel- I genuinly felt like I was going to die I was so ill. Is there a reason why breastfeeding means you cant have the injections or a higher dose of tablets?

I would fight for the injections with your surgery or look into getting them private. Look up symptoms of low b12 and see if you can join the support groups online as they can explain a lot better about it, the symptoms the treatments etc.

And yes surgeries have been trying to put people on tablets and take away injections for years but again if you consult the support groups and medical studies they all say not to do this if people are benefitting from treatment and that the test for pernicious anaemia (anti intrinsic ab test?) Is very unreliable and has a lot of false negatives

Your gp should really be investigating if there's a reason behind your low b12. There are a lot of things it could be - taking PPI medication like Omeprazole, having coeliac disease, vegan or vegetarian diet.
When I was diagnosed with pernicious anaemia the presumption was that in the absence of a recognised reason for low B12, even if a negative IF test you had pernicious anaemia.
in your situation, I would pay for a private blood test if your gp won't do it - get active b12 levels checked and IF if you can get one done privately. Do that before taking any supplements.

I think you just got an over cautious pharmacist (or a counter assistant)

I would buy online. You can be reassured, normal doses of cyanocobalamin are safe in BF

www.nhs.uk/medicines/cyanocobalamin/#:~:text=Pregnancy%20and%20breastfeeding&text=Cyanocobalamin%20does%20pass%20into%20breast,doctor%20as%20soon%20as%20possible.

Just go to Holland and Barrett and buy a pot

Yeah I agree. My platlets were below the bracket aswell but as the rest of the group were normal she just marked them all as normal!

But god forbid you ask my practice any questions about your results or query any of their comments 😵‍💫

Thank you for this!
You've articulated exactly how I feel!

Because I don't have to stop BF if I can get the correct dosage of supplements and all is well. I wouldn't just stop something which is important to me and more importantly to my son.

Could you make an appointment with a different GP at the surgery explaining everything you've said here? Sometimes a different GP is all that's needed and makes a world of difference

This is the same dose as you'd get on prescription but freely available to buy in-store or online without having to discuss with an over zealous pharmacy technician

Pharmacies always err on the side of caution when it comes to pregnancy and breastfeeding because it's not ethical to do proper studies. I always go on what my GP says.

My local pharmacy can be a bit over zealous with OTC medicine. E.g. they won't sell ferrous fumarate (iron) unless the GP 'recommends' it - not even a prescription, but a recommendation, whatever that means. I'm not even breastfeeding. I bought it online instead.

My pharmacy refused thrush treatment. Anyone over 60 has to see GP or nurse now

Thank you all! I visited a different pharmacy who said it was fine to take! So all that hassle for nothing 🙈
Bit concerning being given wrong advice really but sadly not all that surprising!
Thanks again for the replies 🥰

You can get it in a supermarket though can't you?

I’m glad you got it sorted. I think the first pharmacist should have provided this basic advice and not worry you and create more hassle (and shit on the GP in the process). Having said that, the GP as the first point of contact could have said take X mcg or whatever. I know in this day and age we can Google everything, and this info could have been found online, however you had sought advice and that should have been provided.