& Hughes, R
Christopher M Stevens for lab assistance
Application of the method to Crohns disease patients treated with infliximab
GPs can prescribe B12 injections following appropriate investigation, which should include: Full blood count to identify macrocytic anaemia Serum B12 and folate levels to confirm deficiency (using laboratory-specific reference ranges) Methylmalonic acid and/or homocysteine when B12 results are borderline Intrinsic factor antibodies if pernicious anaemia is suspected Additional tests depending on clinical presentation (e.g., thyroid function, coeliac serology) When both B12 and folate deficiency are present, B12 should be replaced before folate to avoid precipitating subacute combined degeneration of the spinal cord

(this doesnt need to be specifically within a population with dementiathis is for all people with confirmed vitamin B12 deficiency) Database : EBM Reviews - Cochrane Database of Systematic Reviews 2005 to April 2013, EBM Reviews - ACP Journal Club 1991 to May 2013, EBM Reviews - Database of Abstracts of Reviews of Effects 2nd Quarter 2013, EBM Reviews - Cochrane Central Register of Controlled Trials April 2013, EBM Reviews - Cochrane Methodology Register 3rd Quarter 2012, EBM Reviews - Health Technology Assessment 2nd Quarter 2013, EBM Reviews - NHS Economic Evaluation Database 2nd Quarter 2013, Embase 1980 to 2013 Week 22, Ovid MEDLINE(R) 1946 to May Week 4 2013, Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations June 03, 2013 Search Strategy: Database: CINAHL Suggested Citation This report should be cited as follows: Masucci L, Goeree R