Needles for steroid drugsPeople who suffer from Pernicious Anaemia (PA) could face a long wait for vital vitamin injections due to a manufacturing backlog. 

Pernicious Anaemia Society members were told by the Department for Health last week there is a shortage of B12 injections, with some sufferers facing long waiting lists for their medication.
Around half a million people in the UK currently suffer with PA, a condition where the body can't make enough healthy red blood cells because it doesn't have enough vitamin B12. People who have PA can't absorb enough vitamin B12 from food because they lack intrinsic factor, a protein made in the stomach, which leads to vitamin B12 deficiency.

Vitamin B12 helps the body maintain normal neurological and psychological functions, particularly those aspects of the brain and nerve functions which determine concentration, learning, memory and reasoning.

Symptoms of PA may include fatigue and lethargy, dyspnoea, faintness, palpitations and headaches. The condition may also present with unexplained neurological symptoms such as paraesthesia, numbness, cognitive changes or visual disturbance. Neuropsychiatric features may include irritability, depression, psychosis and dementia. In severe cases, PA can cause heart failure.

Before vitamin B12 treatments were available PA used to be fatal. Now, it is easy to treat with vitamin B12 injections. But without treatment, PA can lead to serious problems with the heart, nerves, and other parts of the body. Some of these problems may be permanent.

Martyn Hooper, chairman of the Pernicious Anaemia Society, said: “At the moment some PA sufferers are facing delays with their prescriptions of Hydroxocobalamin injections.

“Hydroxocobalamin is the form of vitamin B12 used to produce the vitamin commercially. It is easily converted in the body to usable coenzyme forms of vitamin B12. Pharmaceutically, hydroxocobalamin is usually produced as a sterile injectable solution and is used for treatment of the vitamin deficiency.

“Supplies of generic hydroxocobalamin injection are currently limited as a result of manufacturing difficulties. The Department of Health are working with the supplier of this product to help ensure that normal supplies resume as soon as possible.  Please advise your doctor or pharmacist that there are plentiful supplies of the branded injections supplied by Focus Pharmaceuticals (Neo-cytamen) and Amdipharm Mercury Company (Cobalin H).

“If anyone is not able to obtain their injection and develops any neurological symptoms, they are advised to make an emergency appointment with their GP to discuss and consider using sublingual applications of B12 in the form of Methylcobalamin that could be used until prescriptions are available again.” 

Methylcobalamin is an active form of B12. Unlike hydroxocobalomin injections, no conversion process has to take place, so the vitamin is active as soon as it hits the bloodstream.

Health company BetterYou recently produced a sublingual B12 oral spray, formulated in conjunction with Cardiff University, to provide an alternative to the poorly absorbed tablets. Due to the high absorption levels of Boost B12 oral spray, therapeutic doses can be achieved which can make an effective alternative for those waiting for their B12 injections.

Andrew Thomas, founder and managing director at BetterYou, said: “The current shortage of B12 injections will be of concern to those who suffer with PA.

“But with the shortage being only temporary, sufferers can be reassured that they can boost their levels in the meantime through effective supplementation with spray forms of the vitamin commonly proven to be much better absorbed that tablets."