Mar 8, 2020 | Guidelines | 7 comments

What, no loading dose?
I have been helping someone in the county of Lincolnshire to access treatment and I can say with all honesty that it is THE most difficult and frustrating case I have ever taken on.

I have been told on two separate occasions that GP’s in this area don’t give loading doses as there is “no benefit to patients“. Once by a Practice Manager and once by a female District Nurse. Both are seemingly embarrassed about having told me this apparently ‘privelidged information’ about a certain (and hopefully small) group of GP’s.

The Practice Manager now denies saying it and the District Nurse’s superiors also deny it happens and yet the patient still remains ‘unloaded’.

I continue to dig around to get to the truth about this bizarre situation, so if you live in Lincolnshire and have not received your loading dose either, please consider getting in touch and giving me the name of your Practice and GP so that together we can make a change. (This goes for anywhere else in the UK too).

I have reminded the Practice of NICE Guidance. This states that a loading dose of 6 injections should be given and that this every other day frequency should be continued for those with neurological symptoms. This regime exists so that the patient has the best chance of recovery.

My help, or interference as this Practice sees it, is unwelcome and has fallen on deaf ears. Imagine a drawbridge being pulled up and port cullis being heavily dropped. This is arrogance, ignorance and stubbornness at an unprecedented level.

The Clinical Lead at the CCG (Clinical Commissioning Group), who is also a GP has said “the Practice were likely right in regards to their cautious approach” – Shocking! This wet comment smacks of a doctor not wanting to go against a peer rather than making sure (as they should do) that the patient’s needs are at the heart of the matter.

I won’t give up on this patient or on the wider situation, but my persistence causes some health professionals I’m dealing with to become angry …….

Belittling behaviour…
When I explained about the pointlessness of just one B12 injection for someone so severely affected the disgruntled District Nurse I mention above, loudly told me, “YOU ARE JUST A WOMAN!”  (I know, a shocking lack of sisterhood!)

So I agreed with her. 

Obviously she it meant as an insult, but agreeing with someone when they’re insulting you has a miraculous effect. It completely takes the wind out of the sails. But I also added… “This woman wants to help you to help your patients”.

Essentially her statement was correct, I am just a woman;

Just a woman who cares 

Just a woman who wants to make change

But what the nurses statement was really saying was;

“you are ONLY a woman, you are not a nurse like me or a doctor, how can you know all these things and I don’t? How dare you make me feel inadequate?”

I understand her frustration. I understand her annoyance at not knowing about B12 deficiency, I’d be annoyed too…..she was however shouting at the wrong person, perhaps she should have been asking others around her why she hadn’t been taught more about this vitamin than how to give B12 injections.

It’s a fact that most people with B12 deficiency know more about their condition, how it affects them and how it should be treated than their doctor or nurse does. Wouldn’t it be lovely if this truth could be embraced and the patient’s knowledge tapped without the healthcare professional feeling inferior?

The reason that my site and others like it exist is because the teaching of B12 deficiency for those who need it is far too sparse and this needs to change.

Best wishes Tracey


I want to leave you with Becky Hemsley’s wonderful poem –

Like a girl

She drives just like a girl you know
She throws just like one too
She fights just like a girl as well
She’s just no match for you

She also runs just like a girl
And that’s the way she plays
But when they say “just like a girl”
I think they mean to say

And somehow less
Somehow slower, somehow weaker
They think that if she’s ‘like a girl’
They’ll easily defeat her

But girls will go to battle
When they already are bleeding
And girls are great at throwing themselves
Upwards through glass ceilings

Girls are busy navigating progress,
Driving change
And girls are busy winning
Whilst you criticise their game

So tell her that she’s ‘like a girl’ –
She may just prove you right
She may out-play, out-last you,
Win the race and win the fight

‘Cause she’s a driving force
Fighting for her place in this world
And if you try to talk her down
She’ll rise up

Like a girl

Becky Hemsley 2023

If you are a health professional and you and your colleagues want to learn more about B12 deficiency please click here.

If you are experiencing problems with accessing treatment;

For testimonials please click here.

Please note that the NICE link is unavailable outside of the UK.

If I’ve helped please consider buying me a coffee/leaving a virtual tip.
Doing this helps me to offer this free website to you and others around the world.
Thank you, I really do appreciate it.


  1. Karen Hibberts

    Hi Tracy,
    Couldn’t agree more. When I was trying to get injections, (I had neurological symptoms) and hadn’t yet had loading doses, I kept repeating “BMA, paragraph 9.1.2”, almost like a mantra when I was told I didn’t need them, and certainly would NEVER be given every-other-day injections “as three-monthly is plenty”.
    At one stage, my GP asked me if I thought I knew more about B12 than she did. I didn’t answer her but we both just stared at each other.
    It was the neurologist who tested IF and instigated every-other-day injections, which my GP stopped, twice. He had to write to insist that the regime was continued indefinitely.
    Such a terrible ordeal, especially when so unwell.


    • Tracey Witty

      Thanks for commenting Karen and well done for keeping going, not that anyone should have to fight so hard for correct treatment! Best wishes Tracey

  2. Ailsa

    I am a doctor working both as a GP in the NHS and privately in Functional Medicine. Through my own health journey I educated myself about vitamin B12 deficiency. In my NHS practice I test for it loads and treat as per the guidelines from b12d.org. I am amazed what a difference the loading doses make. Maybe these GPs don’t take the trouble to ask if there had been any improvement after the loading doses, I always arrange a follow up.
    In my FM practice we were writing to GPs to ask them to give loading doses. They would test, find it was “normal” irrespective of our functional testing and refuse to give loading doses. We are now starting to give the loading doses ourselves or teach the patients to self administer.

    • Tracey Witty

      Dear Ailsa
      Thank you for your comment. Do you mind my asking what your view on B12 deficiency was prior to your FM Training? Many GP’s are seemingly unaware of NICE Guidance on neurological symptoms and automatically place patients on 3 monthly injections. It’s a crying shame but yes sometimes as far as B12 deficiency goes the middle man or woman needs cutting out in order for the the patient to be well.
      Best wishes

  3. Wendy Grabanski

    You are not only “just” a woman, You ARE compassionate and caring beyond words and have taken so much time in your life to aid others. I seriously can’t live without your help. And I live in the USA. The information you provide is top notch. Thank you from the bottom of my heart for being “just a woman” And a terrific one at that! I have really missed the blog posts… So thank you for this. Sending Hugs from across the sea!

    • Tracey Witty

      Dear Wendy, thank you for your lovely and very kind comment and for the hugs from across the sea, it’s very much appreciated!
      I have been very sparse with my blogging over the past few months but endeavour to correct this!
      My best wishes to a fellow compassionate and caring woman x

  4. Emma

    I was diagnosed in Lincolnshire back in 2009 with a level of 85ng/L when I was 17, I was treated with antidepressants and advice to buy OTC vitamins, despite no dietary reason for deficiency and a family history of pernicious anaemia . For 8 years I then I had levels that zigzagged between 120-224 (whilst on 1200mcg oral b12), doctors insisted that low b12 was just my normal or that my levels were fine because I’d survived on less. Formal treatment plans included offers of more antidepressants and advice to nap less and exercise more and my b12 was frequently labelled satisfactory with lab advice to retest or treat ignored and not passed on to me.

    A formal complaint concluded that my treatment was perfectly acceptable and inline with guidelines. They did not answer WHY I was not offered injections or offered further testing if there was doubt over diagnosis (e.g. homocysteine, MMA). When I finally won my battle to get injections at 25 (b12=127ng/L) and asked for more frequent injections in line with BNF for neuro symptoms (I was awaiting a neurologist referral so they obviously believed I was having neurological symptoms) a haematologist wrote that the sense of wellbeing from b12 injections is addictive, and reduced my injections from 2 to 3 monthly. When I complained he was unaware that the BNF allowed more frequent injections than 3 monthly.


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