B12 and Metabolic Health Consultations Across the UK
GP-led assessment and management of vitamin B12 deficiency, pernicious anaemia, iron deficiency, anaemia, persistent tiredness, unexplained neurological and psychiatric symptoms, and complex or longstanding health problems.
Led by Dr Asim Naqvi MRCGP, an experienced GP with a longstanding clinical interest in B12 deficiency, metabolic medicine and complex chronic conditions.
Our approach looks beyond individual symptoms and blood test results, considering your full medical history, nutritional and metabolic factors, and possible co-existing or alternative medical conditions.
Nationwide consultations are available by telephone or Zoom, with face-to-face appointments at The Forbury Clinic in Reading, Berkshire.
I help people who feel something has been missed...
I’m Dr Asim Naqvi MRCGP, a UK General Practitioner with 30 years of clinical experience and a longstanding interest in vitamin B12 deficiency, metabolic medicine and complex medical problems, particularly where symptoms persist despite treatment or previous investigations.
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, anaemia or fibromyalgia but still do not feel they have a clear explanation or effective management plan.
At B12 Metabolic Clinic, my aim is to look at the full clinical picture – your symptoms, medical history, risk factors, blood results and response to previous treatment – while considering other possible medical conditions that may be contributing.
I draw on my understanding of physiology, biochemistry and the underlying mechanisms of disease, combined with clinical experience, to examine complex symptoms from first principles. This helps me identify potential connections between symptoms, investigate possible causes and develop a more comprehensive, individually tailored management plan.
I offer telephone and video consultations across the UK, alongside face-to-face appointments at The Forbury Clinic in Reading, Berkshire.
Do you feel something has been missed or not fully explained?
You may have been living with symptoms for months or even years, affecting your work, family life, exercise, mood or confidence.
Perhaps you’ve already tried vitamin B12 injections or tablets but your symptoms persist. Your blood tests may have been reported as normal, yet you continue to feel unwell. Or perhaps you have an existing diagnosis but want a more detailed assessment of other possible contributing factors.
You may simply want a second opinion from an experienced GP with a longstanding clinical interest in B12 deficiency, metabolic medicine and complex health problems.
Not every symptom is caused by B12 or iron.
My role is to consider whether a treatable nutritional deficiency or metabolic disturbance may be contributing to your symptoms, while also investigating other possible explanations.
I draw on clinical experience and the underlying principles of physiology and biochemistry to assess how different conditions may overlap and interact.
If your symptoms suggest another diagnosis, require urgent assessment or warrant referral to another medical service, I will explain this and advise you on the appropriate next steps.
Fatigue, weakness and brain fog
Persistent tiredness, reduced energy, poor memory, difficulty concentrating, mental fatigue or feeling mentally slower than usual.Pins and needles, numbness and neurological symptoms
Tingling, burning sensations, nerve pain, muscle weakness, altered sensation, poor coordination or problems with balance.Dizziness, light-headedness and palpitations
Symptoms such as dizziness on standing, episodes of light-headedness, palpitations or other possible disturbances of autonomic nervous system function. These may have several possible causes requiring careful assessment.Mood, cognitive and psychological symptoms
Low mood, anxiety, poor concentration, memory problems or other changes in mental wellbeing, particularly when there may be associated physical symptoms or potentially contributing medical conditions.Mouth symptoms, headaches and persistent pain
Burning mouth, glossitis, angular cheilitis, recurrent mouth ulcers, headaches, migraines or persistent pain, including symptoms sometimes associated with fibromyalgia.Mouth symptoms, headaches and persistent pain
Burning mouth, glossitis, angular cheilitis, recurrent mouth ulcers, headaches, migraines or persistent pain, including symptoms sometimes associated with fibromyalgia.Persistent symptoms despite treatment or previous investigations
Ongoing symptoms despite B12 tablets or injections, or concerns relating to pernicious anaemia or autoimmune gastritis. I also see patients with complex conditions such as fibromyalgia, ME/CFS, long Covid and functional neurological disorder who wish to explore whether nutritional, metabolic or other co-existing medical problems may be contributing to their symptoms.
Looking Beyond the B12 Blood Test
Vitamin B12 deficiency is often thought of as a blood disorder associated with anaemia. However, its effects can extend far beyond the blood, particularly affecting the nervous system.
Symptoms may include persistent tiredness, memory and concentration difficulties, mood changes, pins and needles, numbness, mouth symptoms and problems with balance or coordination. Importantly, B12 deficiency can occur without anaemia or enlarged red blood cells (macrocytosis).
NICE guidance (NG239) recognises the importance of considering symptoms, clinical signs, risk factors and blood test results together. A blood test alone does not always provide the complete clinical picture.
Iron deficiency, folate deficiency, vitamin D deficiency, thyroid disease, autoimmune gastritis, medication effects, problems with nutrient absorption and other medical conditions may coexist, contribute to symptoms or provide alternative explanations.
Sometimes there are several pieces to the clinical jigsaw. My approach is to consider how these different factors may interact, rather than assuming that one blood test or diagnosis explains everything.
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
Every patient is different. Whether you’re concerned about B12 deficiency, pernicious anaemia, iron deficiency or persistent unexplained symptoms, I start by understanding your individual clinical picture.
My approach follows four key stages.
Understanding your symptoms
We begin with a detailed consultation exploring your symptoms, medical history, previous diagnoses, medication, risk factors and how your health is affecting your everyday life.
I also review previous investigations and treatment, including what has or hasn’t helped.
Investigations where appropriate
I review your existing blood results and consider whether additional investigations may help clarify your symptoms.
These may include B12, folate, iron studies, homocysteine, thyroid function and other relevant tests.
A personalised management plan
I explain my clinical assessment, including possible diagnoses, contributing factors and the reasoning behind any recommended treatment. Co-existing and alternate diagnosis are always considered as part of the systematic approach
Depending on your circumstances, this may include B12 replacement, management of iron or other nutritional deficiencies, further investigations, monitoring or referral to another medical service.
Where appropriate, I can also communicate my findings and recommendations to your usual GP.
Reviewing your progress
Treatment is not always the end of the process.
Where follow-up is needed, I review how your symptoms and daily functioning have changed, assess your response to treatment and consider whether the original diagnosis and management plan remain appropriate.
If you’re not improving as expected, we consider why and what should happen next.
Telephone and video consultations throughout the UK, or face-to-face appointments in Reading.
B12 does not work in isolation
The body relies on thousands of interconnected biochemical reactions. Vitamin B12, folate, iron and other nutrients are involved in essential processes such as DNA synthesis, red blood cell production, oxygen transport, nerve function and cellular metabolism.
Some biochemical pathways overlap directly, while others converge on the same physiological functions. When more than one pathway is affected, the resulting symptoms can overlap, interact or compound one another. This helps explain why patients may experience several symptoms together, or why treating one deficiency may only partly improve their health.
Iron and ferritin
Folate and vitamin D
Thyroid and inflammation
Absorption, medications and autoimmunity
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
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.
Ready to Discuss Your Symptoms?
Book a consultation with Dr Asim Naqvi MRCGP to discuss your concerns, review your previous investigations and agree the most appropriate next steps.
Consultations available nationwide by telephone or Zoom, or face-to-face at The Forbury Clinic in Reading.
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.
- Do you offer consultations throughout the UK?
Yes. I offer telephone and Zoom consultations to patients across the UK, as well as face-to-face appointments at The Forbury Clinic in Reading, Berkshire.
Remote consultations are suitable for many assessments, including reviewing symptoms, medical history, investigations and treatment plans. Where a physical examination or in-person investigation is necessary, I will advise accordingly.
- Do I need blood tests before booking an appointment?
No. A consultation is the starting point.
If you already have NHS or private blood results, these can be reviewed as part of your assessment. You will be advised how to provide them securely.
Further investigations can be arranged where clinically appropriate. I do not offer standalone blood-testing packages without clinical assessment, as results need to be interpreted in the context of your symptoms and medical history.
- Can I have B12 deficiency despite normal blood tests?
Yes, depending on which tests have been performed and the clinical circumstances.
B12 deficiency can occur without anaemia or enlarged red blood cells (macrocytosis). NICE guidance specifically recognises this.
B12 blood test results also require careful interpretation. Some results fall within an indeterminate range, while previous B12 supplementation can affect measured concentrations.
I consider your symptoms, risk factors and medical history alongside the investigations. If B12 deficiency appears unlikely, I will also consider other explanations.
- Can B12 deficiency cause neurological or psychiatric symptoms?
B12 deficiency can affect the nervous system and may cause tiredness, pins and needles, numbness, balance problems, memory difficulties and impaired concentration.
It can also be associated with mood and mental health symptoms, including depression and anxiety, and occasionally more severe psychiatric presentations.
However, these symptoms can have many different causes. Assessment should consider the wider clinical picture rather than automatically attributing them to B12 deficiency.
- I’m already taking B12 tablets or injections. Can you still assess me?
Yes. I regularly assess patients who are already receiving B12 treatment but continue to experience symptoms or have concerns about their treatment.
I will review your original symptoms, previous investigations, type and frequency of treatment, and how you have responded.
B12 replacement can alter subsequent blood test results, making clinical history and treatment response particularly important.
I also consider whether other deficiencies or medical conditions may be contributing to persistent symptoms.
- 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.
- Do you provide B12 injections?
Yes, we provide vitamin B12 injections at The Forbury Clinic in Reading, Berkshire, where clinically appropriate.
Before recommending treatment, I assess your symptoms, medical history, previous blood results and response to any earlier B12 treatment.
Where injections are indicated, I will discuss the appropriate treatment regimen and follow-up arrangements, taking account of your individual clinical needs.
Patients throughout the UK can also book telephone or Zoom consultations for assessment and treatment advice.
- 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 assess pernicious anaemia and autoimmune gastritis?
Yes. I assess patients with suspected or diagnosed pernicious anaemia, including B12 deficiency associated with autoimmune gastritis.
Autoimmune gastritis can interfere with B12 absorption and may also affect iron absorption.
A negative intrinsic-factor antibody test does not necessarily exclude autoimmune gastritis. Depending on the clinical picture, further investigations may be appropriate.
Where an irreversible cause of B12 deficiency is identified, lifelong B12 replacement may be necessary.
- 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.
- Can you help if I have fibromyalgia, FND, ME/CFS or long Covid?
Yes. I see patients with complex chronic conditions, particularly where symptoms remain troublesome or the possible contribution of other medical conditions has not been fully explored.
These conditions may share symptoms with nutritional deficiencies, hormonal disorders and other medical problems.
My role is to investigate potentially treatable co-existing conditions and consider whether they may be contributing to your symptoms.
- 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.
- Do you provide iron infusions?
No. B12 Metabolic Clinic does not administer iron infusions.
I assess iron deficiency, low ferritin and anaemia, including the underlying causes and response to previous treatment.
If an iron infusion may be appropriate, I can advise on further investigation, management and referral to a suitable provider.
- 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.
- Can you write to my NHS GP or another healthcare professional?
Yes, where appropriate.
Following your consultation, I can provide a clinical letter summarising relevant findings, investigations, my assessment and recommendations for further management.
This may help coordinate care with your NHS GP or another healthcare professional.