Vitamin B12 tests

The use of vitamin B12 tests in Switzerland has risen sharply in recent years. Patients who are at risk of, or thought to suffer from, vitamin B12 deficiency undergo a test. The aim of the report was to identify the advantages and disadvantages of various vitamin B12 tests and establish whether tests are needed at all before dispensing vitamin B12.

The investigated studies had differing objectives. Some were concerned with the diagnostic accuracy of vitamin B12 tests, others with the effect of the test results on the subsequent course of action by the treating professionals. Other studies investigated the dispensing of vitamin B12 and the corresponding dosages and therapeutic outcomes. The results of the report do not allow any clear conclusions to be drawn concerning the tests. It is clear, however, that long-term vitamin B12 deficiency can lead to physical damage.

One social and organisational issue was the fact that vitamins are becoming increasingly "medicalised" and that unnecessary tests are consequently on the rise. Options for reducing unnecessary vitamin B12 tests in practice include better information for doctors, longer consultation times and the removal of vitamin B12 tests from test kits. The ethical question concerning the possibility of incorrect test results showed that any resulting damage can be considered to be minimal.

The report concludes that the existing findings do not indicate whether a vitamin B12 test or test combination should be used, and if so which ones, or whether the tests have any influence on the treatment. Moreover, no consistent procedure is followed by Swiss doctors as to when, and if so how many and what, test methods they use and in what order.