National B12 and metabolic health consultations in Reading
GP-led assessment of B12 deficiency, pernicious anaemia, iron deficiency, anaemia and persistent symptoms with Dr Asim Naqvi MRCGP.
A national service for patients across the UK by telephone or Zoom, with face-to-face consultations at the Forbury Clinic in Reading.
I help people who feel something has been missed...
I’m Dr Asim Naqvi MRCGP, a UK General Practitioner with many years of clinical experience and a strong interest in B12 deficiency, pernicious anaemia, iron deficiency, anaemia and complex symptoms.
I often see patients who have been living with symptoms for months or years. Some have been told their blood tests are “normal” but still feel unwell. Others have already been diagnosed with B12 deficiency, pernicious anaemia, iron deficiency or anaemia but still do not feel they have a clear plan.
At B12 Metabolic Clinic in Reading, my aim is to look at the whole picture – your symptoms, medical history, risk factors, blood results and response to any previous treatment – before advising on the most sensible next step.
This is not a general vitamin clinic and it is not a narrow injection or infusion service. It is a GP-led assessment clinic for people with possible B12, iron or related metabolic issues, especially where symptoms are complex, persistent or have not been fully explained.
You may come to see me because you feel something has not been properly explained.
Your symptoms may be affecting your work, family life, exercise, mood or confidence. You may have tried B12 injections or tablets already but still do not feel right. You may have low-normal results that have been dismissed. Or you may simply want a careful second opinion from a GP who has spent years studying this area.
Not every symptom is caused by B12 or iron.
My role is to avoid missing a treatable deficiency or metabolic issue while still practising careful, honest medicine. If your symptoms suggest another diagnosis, urgent assessment or specialist referral, I will explain that clearly.
Fatigue, weakness and brain fog
This may include severe tiredness, poor memory, reduced concentration or feeling mentally slower than usual.Pins and needles, numbness or nerve-type symptoms
Some people describe burning feet, tingling, nerve pain, poor coordination or balance problems.Dizziness, light-headedness or palpitations
These symptoms can be unsettling, especially when routine checks have not given a clear answer.Mouth, mood or pain symptoms
This may include burning mouth, glossitis, angular cheilitis, mouth ulcers, low mood, anxiety, headaches, migraines or pain syndromes.Low iron, heavy periods or recurrent deficiency
I see patients with iron deficiency, low ferritin, iron deficiency anaemia or symptoms that return after previous treatment.Symptoms despite treatment or previous reassurance
This may include symptoms despite B12 injections or tablets, suspected pernicious anaemia, autoimmune gastritis, long Covid, ME/CFS, fibromyalgia, functional neurological disorder or medically unexplained symptoms.
A different kind of B12 assessment
B12 deficiency is often thought of as a blood problem that causes anaemia. In real clinical practice, symptoms can be wider than that.
Some people have neurological, cognitive, mood, mouth, fatigue or balance symptoms, and anaemia may not always be obvious at the start. NICE guidance recognises that assessment should consider symptoms, signs, risk factors and blood test results together, rather than relying on one result alone.
Iron deficiency, folate problems, vitamin D deficiency, thyroid disease, autoimmune gastritis, medication effects, gut absorption problems and other medical issues can overlap. Sometimes there are several pieces to the clinical jigsaw.
I do not treat a number on a screen. I look at the person in front of me, the pattern of symptoms, the risk factors, the blood results, the possible causes and the response to any previous treatment.
I also look for other contributors, because B12 is not always the whole story.
How I can help you
Private GP-led assessment
A careful consultation to review your symptoms, history, results and possible causes before agreeing the next sensible step.
Private blood tests
Focused testing for B12, folate, ferritin, iron, anaemia, vitamin D, thyroid function and related markers where appropriate.
B12 injections
Assessment and treatment support for B12 injections when they are clinically appropriate, with clear advice on follow-up.
Pernicious anaemia support
Help understanding suspected or diagnosed pernicious anaemia, autoimmune gastritis, B12 absorption and monitoring.
Iron deficiency and anaemia assessment
Assessment of low ferritin, iron deficiency and anaemia, including whether an iron infusion may be suitable.
Follow-up and response review
Structured review of symptoms, blood results and treatment response so the plan can be adjusted where needed.
B12 does not work in isolation
Iron, folate, vitamin D, thyroid function, inflammation, autoimmune disease, gut health and medication effects can all influence how someone feels. Patients often have more than one contributor.
That is why I do not look at B12 on its own. I look for patterns and overlaps that may explain why symptoms are persisting, why treatment has only partly helped or why previous results have felt confusing.
Iron and ferritin
Folate and vitamin D
Thyroid and inflammation
Absorption and autoimmune background
What happens when you book a consultation
You tell me what has been happening
I start by listening. I want to understand what has changed, how long your symptoms have been present and how they are affecting your work, family life, exercise, mood and confidence.
I review your background carefully
I look at your medical history, medication, diet, gut symptoms, menstrual history, family history, previous diagnoses and any past investigations.
I assess your risk factors
This may include autoimmune disease, gut problems, medication effects, vegan or restricted diet, nitrous oxide exposure, bariatric surgery, heavy periods or a family history of related conditions.
I interpret your results in context
I review relevant results such as B12, folate, ferritin, iron studies, vitamin D, thyroid markers and other tests where available.
I explain my clinical opinion clearly
I will explain what I think may be going on, what the results support, what they do not prove and whether B12, iron or another issue seems most relevant.
We agree a practical plan
Your plan may include further testing, B12 treatment, iron treatment, monitoring, symptom tracking, lifestyle advice, a GP letter or referral where appropriate.
What makes my approach different?
I offer GP-led whole-person assessment
I look at B12 plus cofactors
I use clinical pattern recognition
I practise honest medicine
I believe follow-up matters
I am building education in this area
I see patients through B12 Metabolic Clinic in Reading, Berkshire and support people from the surrounding area.
Remote consultations may also be available where clinically appropriate. If blood tests, B12 injections or iron infusions are needed, I will explain what can be arranged safely and practically.
B12 Metabolic Clinic is not an emergency service
Please seek urgent help through NHS 111, 999 or A&E if you have severe chest pain, sudden shortness of breath, fainting, weakness on one side of the body, new confusion, black stools, heavy bleeding, rapidly worsening symptoms or anything that feels severe, sudden or unsafe to wait.
Book an appointment with me
If you are worried about B12 deficiency, pernicious anaemia, iron deficiency, anaemia or symptoms that have not been fully explained, you do not need to work it out alone.
I will take time to listen, review the evidence carefully and help you understand the most sensible next step.
Frequently asked questions
If you are considering an appointment, you may have questions about blood tests, B12 injections, iron infusions or whether this clinic is right for your symptoms. I have answered some of the most common questions below, but if you are unsure, you are welcome to get in touch before booking.
- Can I book if my problem is not related to B12?
Yes. I offer general GP consultations for medical concerns across all areas of general practice. My particular interest is the neurological manifestations of B12 deficiency, but you do not need a B12 question to book. Where a problem needs urgent or specialist care, I will advise on the appropriate service.
- Do I need blood tests before an appointment?
No. Please share any existing results if you have them. I will advise whether more testing is useful after assessing your symptoms and history.
- Can a normal blood count rule out B12 deficiency?
No. NICE says the absence of anaemia or macrocytosis alone should not exclude B12 deficiency. Other clinical information and testing may still be needed.
- What does B12 Metabolic Clinic specialise in?
The main focus of the clinic is vitamin B12 deficiency and related metabolic problems.
I see patients with suspected or confirmed B12 deficiency, suspected pernicious anaemia/autoimmune gastritis, neurological symptoms, fatigue, cognitive symptoms, problems despite previous B12 treatment and complex symptoms where B12 deficiency may have been overlooked.
I also consider related deficiencies and other medical conditions where they are relevant. B12 is important, but it is not automatically the explanation for every symptom.
- Can B12 deficiency affect mental health?
Yes. NICE lists symptoms of depression, anxiety and psychosis among the possible mental health problems associated with B12 deficiency; memory and concentration can be affected too. I look at your wider health and circumstances before deciding whether B12 testing or another assessment is appropriate.
- Can I see you if my B12 blood test has been reported as normal?
Yes.
A B12 result should be interpreted alongside your symptoms, risk factors, medical history and whether you have already been taking B12.
Current NICE guidance recognises an intermediate range in which B12 deficiency remains possible. B12 tablets, sprays, injections and other supplements can also raise the measured B12 concentration and make the result more difficult to interpret.
If B12 deficiency appears unlikely, I will say so and consider other explanations for your symptoms.
- Do you provide iron infusions?
No. I assess iron deficiency and can advise on treatment, further investigation or an appropriate referral if an infusion needs to be considered.
- Can you have B12 deficiency without anaemia or enlarged red blood cells?
Yes.
Vitamin B12 deficiency should not be excluded simply because your haemoglobin and mean cell volume (MCV) are normal.
B12 deficiency can cause neurological, cognitive and other symptoms without anaemia or macrocytosis. This is specifically recognised in current NICE guidance.
- Will B12 treatment cure fibromyalgia, FND or ME/CFS?
No such result can be promised. I can assess and treat B12 deficiency when clinically indicated, and review other conditions alongside an established diagnosis.
- I am already taking B12. Can you still assess me?
Yes.
Please tell me exactly what you have been taking, including tablets, sprays, patches or injections, the dose, frequency and when you started.
B12 supplementation can alter blood test results, so knowing what treatment you have already received is important when interpreting them.
Your symptoms before treatment and how they have changed with treatment can also provide useful clinical information.
- Can I have a remote appointment?
Yes. I see patients across the UK by telephone or video, including for initial assessment, results interpretation and follow-up when clinically suitable. Face-to-face appointments are also available at The Forbury Clinic in Reading.
- Do I need new blood tests before booking a consultation?
No.
If you already have NHS or private blood results, send them to me before your consultation if possible. Older results can also be useful because they may show how your B12, folate, ferritin and other markers have changed over time.
After assessing you, I can advise whether any additional investigations would be useful rather than ordering tests unnecessarily.
Where B12 deficiency is being investigated for the first time, blood samples are ideally taken before starting replacement. However, treatment should not be unnecessarily delayed where there are significant neurological concerns.
- Do you provide B12 injections?
I assess patients to determine whether B12 treatment is clinically appropriate and what form of treatment should be considered.
Where intramuscular B12 is appropriate, I can discuss treatment and follow-up as part of an individual clinical plan.
Response to treatment varies considerably between patients, so I am interested not simply in a blood-test number but also in whether symptoms and day-to-day function improve.
- How do you decide whether B12 is actually causing my symptoms?
There is no single symptom that proves B12 deficiency.
I look for a pattern: your symptoms, neurological features, medical and family history, medications, diet, gastrointestinal problems, autoimmune background, previous blood results and response to any previous treatment.
I also consider other possible diagnoses. A person can have more than one problem at the same time.
The aim is not to attribute everything to B12. It is to identify whether B12 deficiency is likely to be an important part of the clinical picture and what else may need investigating.
- Do you see patients with pernicious anaemia?
Yes.
I see patients with diagnosed or suspected pernicious anaemia, now increasingly described as vitamin B12 deficiency associated with autoimmune gastritis.
A negative intrinsic-factor antibody test does not necessarily exclude autoimmune gastritis. If the clinical picture suggests an absorption or autoimmune problem, this can be considered as part of the assessment.
Some causes of B12 deficiency are permanent and require lifelong replacement.