The most common cause of Vitamin B12 deficiency is pernicious anaemia, however, it is estimated that 20% of the over 60s are deficient in B12, and 11% of those who follow a vegan diet are also deficient. We also offer private blood tests and wellness screening to confirm and give you peace of mind.

A healthy body needs Vitamin B12 to produce healthy red blood cells that can take oxygenated blood around the body and keep the central nervous system functioning correctly. If there is a lack of B12 in your system, it can lead to nerve damage.

As a CQC registered clinic, Blemish Clinic has access to a third-party laboratory and can run health checks and screening tests to evaluate circulating levels of Vitamin B12 in your blood. If you have low levels or a proven deficiency, you may benefit from supplementation which can be discussed during a consultation where you may be prescribed Vitamin B12 booster injections. We can also advise on lifestyle changes, which may help those without an underlying deficiency.

Conditions treated with Vitamin B12 injections include:

Deficiency of Vitamin B12 caused by pernicious anaemia, ageing, or diet (vegan, strict vegetarian, or restricted) which lacks supplementation.


There are a lot of B vitamins, and we need a little bit of all of them to maintain a healthy body. Their primary roles vary from making energy from the food we eat by releasing carbohydrates and breaking down amino acids, to creating red blood cells, and transporting oxygen and nutrients around the body in the blood. 

Here is a full list of B vitamins: thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), biotin (B7), folate/folacin or folic acid (B9) and cobalamins (B12).

B vitamins can be found in meat, oily fish, cheese, eggs, yeast extract (e.g., Marmite), and leafy greens including broccoli, peas, and brussels sprouts. In fact, many food products including breads and cereals are fortified with extra B vitamins, including B12 and folic acid or folate (B9), which go hand in hand when we look at most B vitamin deficiencies. 

Vitamin B12 is needed to create red blood cells and is vital in the function and development of brain and nerve cells, your central nervous system. We get most of it from animal-derived products within our diet. The body can store Vitamin B12, unlike many other vitamins needed to remain healthy and does so in the liver.

It is uncommon for most healthy people to not get enough Vitamin B12 from their diet, but it can be a problem depending on your age, diet, or underlying medical conditions.

A deficiency or lack of Vitamin B12 is quite common in the over 65s, those diagnosed with pernicious anaemia, and in anyone who follows a vegan, strict vegetarian, or extreme/fad/restricted diet for a long time without taking a B12 supplement or eating fortified foods. Food Standards Agency data shows that more and more people are dramatically reducing their consumption of meat, with a rise in plant-based menus and offerings in the supermarkets.

The National Institute for Health and Care Excellence (NICE) notes that the prevalence of Vitamin B12 deficiency is approximately 6% in those under 60 years old, rising to 20% in the over 60s. Approximately 11% of those who follow vegan diets are also deficient in B12. NICE notes that pernicious anaemia is the most common cause of Vitamin B12 deficiency in those aged 40-70, with an average onset age of 60 in white people and 50 in black people, although it can affect black women at a younger age.

Pernicious anaemia is caused by your immune system preventing your stomach and gut from absorbing B12 from your food. This is the common, diagnosed cause of B12 deficiency in the UK. Some medications can also affect absorption of Vitamin B12 in the gut, and B12 deficiency can be an issue if you have had weight loss surgery.

If you are low in Vitamin B12 or have a deficiency anaemia, you will not be creating enough red blood cells and the ones you do make might be defective, being abnormally large. This means that they cannot carry oxygenated blood around the body properly, leading to nerve damage or neuropathy.

You may feel tired or irritable, with low energy, muscle weakness and trouble walking, pins and needles or numbness, a sore mouth, or have problems with memory, confusion, or depression. Of course, these symptoms can also be associated with a busy or stressful life where you may be grabbing food on the go and not looking after your diet, which can also lead to transient low Vitamin B12 levels.

With a simple blood test, we can easily check your Vitamin B12 levels and determine if you have a deficiency and may benefit from supplementation. All of this will be discussed during a consultation, where a full medical history will be taken.

If you have a Vitamin B12 deficiency and pernicious anaemia which disrupts your ability to absorb B12 from your food, regular intramuscular injections of Vitamin B12 will bypass the need for gut absorption and deliver the vitamin directly into your bloodstream.

If you have transient low levels of Vitamin B12 due to diet and lifestyle, you can still benefit from restorative B12 booster shots to improve fatigue, mood, and motivation as a ‘pick-me up’ and supplementation for the lack of B12 in your diet.

Vitamin B12 is available in four different types – methylcobalamin, adenosylcobalamin, cyanocobalamin, and hydroxocobalamin.

Occurring naturally in food, methylcobalamin and adenosylcobalamin work together in the body to provide most of the Vitamin B12 needed by an otherwise healthy person.

Methylcobalamin and adenosylcobalamin are in the marketplace as a non-prescription, injectable, nutritional supplement and a tablet. The two must be combined to be effective, but as methylcobalamin is not a licensed prescription medicine in the UK, it is not recommended by UK health authorities, nor it is not available through Blemish Clinic.

NICE (National Institute for Health and Care Excellence) recommends two types of prescription only Vitamin B12 medicines that can be used for treating Vitamin B12 deficiencies – hydroxocobalamin and cyanocobalamin.

Cyanocobalamin is an artificial form of B12 available as a prescription injection. The body converts it to methylcobalamin and adenosylcobalamin so that it can be used. The B12 found in tablet supplements in health food stores and in fortified breads and cereals is usually cyanocobalamin because it is a more cost-effective form of B12. It is also the cheaper option of the two medicines but must be given more regularly (one per month) which makes it less convenient for most people.

Hydroxocobalamin is produced naturally by gut bacteria when digesting food. It is also a prescription injection in an artificial form of B12 that can be easily absorbed and used by the body. This prescription form of B12 is the one most often recommended by healthcare professionals, including primary healthcare services, because it stays in the body for longer, only requiring repeat injection every three months. This is also the preferred B12 solution provide at Blemish Clinic and because we are CQC registered we can offer both prescribing services and diagnostic screening for Vitamin B12 deficiency using blood tests. We there use hydroxocobalamin for B12 injections as the optimum choice for our patients.

Injections are delivered intramuscularly, in the same way as you may be familiar for vaccinations. These are well tolerated by most people with little to no pain, apart from the sensation of a sharp scratch.

Vitamin B12 injections are unlikely to cause harm as there is no risk of overdose.

When we ingest Vitamin B12 via our food and there is an excess, the body will excrete it through urine. With intramuscular injections of B12, any excess will result in high levels within your blood so you may experience side effects such as headache, dizziness, tiredness, or gastrointestinal issues including nausea, until your body has metabolised any excess through your kidneys enroute to excretion via urine. If this happens, and you do have more than your body needs, you may spot a colour change in your urine, making it pink.

You should start to notice improvements in symptoms related to Vitamin B12 deficiency within a few days to a week. You will require repeat injections every three months to maintain your levels.

We believe in being transparent with our prices and want you to be fully aware and comfortable with the cost of your treatment. A full list of our prices can be found here. We will always agree a final price with you though before treatment commences.

What to expect


Vitamin B12 injections are given intramuscularly for those with a B12 deficiency related to age, pernicious anaemia, or low levels caused by a vegan or restrictive diet without supplementation.

How it works

Vitamin B12 is delivered by intramuscular injection, in the same way as common vaccinations. This will quickly elevate levels of B12 circulating in the blood, improving the health of red blood cells, and relieving symptoms related to a poor circulation of oxygenated blood.


You should expect the symptoms associated with low levels of Vitamin B12 to improve within days to a week of having the injection or booster shot of B12.

Treatment Time

You will attend a consultation for your initial appointment, which may include taking a blood sample for testing to confirm a Vitamin B12 deficiency. Depending on your results, and consultation, you may be prescribed Vitamin B12 booster injections. The treatment itself is very quick and ongoing appointments are very short.

Pain / Discomfort Level

The injection is well tolerated by most people, and some do not feel it. You will be told to expect a short, sharp scratch as the injection is delivered.

Recovery Time

There is no recovery time or aftercare required following Vitamin B12 injection.


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