Weight & metabolic health
Vitamin B12 & deficiencies
We test for and treat vitamin B12 deficiency, including injections where they are needed. B12 deficiency is common and easily treated, but it always has a reason — and finding the reason determines whether you need tablets, injections, or injections for life.
Come in if you have
- Persistent tiredness, or feeling foggy and forgetful
- Numbness, tingling or pins and needles in hands or feet
- You take metformin, or long-term reflux medication
- You are vegetarian or vegan, or have had weight-loss surgery
- You are already having B12 injections and want your levels reviewed
What happens at your visit
- We test B12, and usually folate, iron and a full blood count alongside it, since these overlap.
- We look for why it is low — diet, absorption, medication or an autoimmune cause.
- We treat according to the cause, which decides between tablets and injections.
- We recheck to confirm it has worked, and set a monitoring interval.
Test before treating
B12 injections are widely offered as an energy boost, often without any testing. They are unlikely to do harm, but they skip the question that matters: why is it low?
That answer changes the treatment entirely. Dietary shortfall responds to tablets. An absorption problem does not — and if the cause is pernicious anemia, an autoimmune condition, you need treatment for life rather than a course of shots.
Injecting first also makes the diagnosis harder afterwards, because levels no longer reflect your baseline.
Who is likely to be low
- Vegetarians and vegans — B12 comes almost entirely from animal foods
- People on metformin — reduces absorption over years, and is common enough that periodic checking is sensible
- People on long-term reflux medication — stomach acid is needed to absorb it
- After weight-loss or stomach surgery — the absorption site may be bypassed
- Older adults — absorption declines with age
- Pernicious anemia — autoimmune, and needs lifelong treatment
Why catching it early matters
Low B12 affects nerves as well as blood. The tiredness and fogginess improve quickly with treatment, but the numbness and tingling take much longer — and if the deficiency has gone unrecognised for a long time, some nerve damage may not fully reverse.
That is the real argument for testing when symptoms suggest it rather than waiting.
What we check alongside
B12, folate, iron and a full blood count usually go together, because they cause overlapping symptoms and are often low together. Thyroid too, if tiredness is the main complaint. Testing one in isolation frequently leaves the actual cause undiscovered.
Common questions
- Can I just get a B12 shot?
- We would want to test first. B12 injections are harmless enough, but giving them without testing means never finding out why you were low — and some causes, like pernicious anemia, mean you need lifelong treatment rather than a course.
- Tablets or injections?
- It depends on the cause. If the problem is dietary intake, tablets usually work well. If your body cannot absorb B12 — after certain surgery, or with pernicious anemia — tablets will not fix it and injections are needed.
- Why does my medication cause this?
- Metformin reduces B12 absorption over time, and so do long-term acid-reducing medications. Both are worth taking if you need them — the answer is monitoring B12 rather than stopping the drug.
- How quickly will I feel better?
- Energy and mood often improve within weeks. Nerve symptoms — numbness and tingling — take longer and may not fully resolve if the deficiency went on a long time, which is the main argument for catching it early.
This page explains how we care for this condition at our office. It is general information, not medical advice for your specific situation — please talk to us about your own care.
Ready to get this looked at?
Call us or send a request and we will get you in — often the same or next day.