Giving You Back YOUR Life

BOOK Vitamin B12 deficiency in clinical practice

At last - the book "Vitamin B12 deficiency in Clinical Practice" (subtitle "Doctor, you gave me my life back!" by Dr Joseph Alexander "Chandy" Kayyalackakom and Hugo Minney PhD is available from Amazon.

B12d book Front Cover

The book describes Dr Chandy's findings over 46 years of clinical practice, working as a GP in Horden, a village near Peterlee in County Durham.  During that time, Dr Chandy looked after an average of 5760 people, many of whom had lived in Horden their whole lives, been born, grown up, got married, had their own children, all under the care and love of this local GP.  In some cases, up to 5 generations fell under his care (obviously in that 40 years only the last few generations were born!)

Dr Chandy noticed that people were suffering from symptoms that looked to him like B12 deficiency.  Whereas he'd seen it previously with Brahmin (who are strict vegetarians and don't eat any meat or dairy), here he was seeing it in British people who did eat meat.  He asked for tests, and they were refused at first.  When the tests eventually confirmed B12 deficiency, he began treatment and then saw how often the same symptoms came up, and how well it responded to treatment.

Dr Chandy was the first to notice that B12 deficiency can occur without macrocytosis - the view at the time was that this was a blood disease, whereas we now know that the main symptoms are in the nervous system but the cause(s) could be much more difficult to determine.

Dr C was also the first to note that folate levels in the blood are far more affected by B12 deficiency than by folate intake.  With the same folate in the diet, blood levels of flate rose rapidly when a patient received B12 supplements by injection.

The book describes what B12 deficiency is, how to diagnose it, how to treat it, and then goes through body system by body system, how it manifests in different ways.  We've illustrated it with 26 case studies of the more than 1000 patients who received treatment at the surgery.

Black and white copy (ISBN 978-1090400819) is available for (prices approximate) £6.15 (US $8.05),

Colour copy (ISBN 978-1096782919) for £23.55.  Note that although there is a lot of colour in the book, it is designed to be readable in the black and white version.  I'm sorry but that really is the price difference and cost of printing - the charity doesn't get any money from selling these books.  

It's 299 pages, which means that if you want a paper copy, it's almost certainly cheaper to buy from Amazon than to print at home unless you have a very expensive work printer which prints very cheaply.

Also see the Table of Case Studies, Tables and Figures to help you download the right chapter.

Download it

Because of its size, we recommend you download chapter by chapter.  However in the light of improved internet speeds, the full book can be downloaded from <here>. The full book is in Quarto layout (international book size), the individual chapters are on A4.

Title page and Table of Contents


Chapter 1 Vitamin B12: a profile

Chapter 2 How to diagnose Vitamin B12 deficiency

Chapter 3 Treating B12 deficiency

Chapter 4 Megaloblastic anaemia - not the only way to diagnose B12 deficiency

Chapter 5 Vitamin B12 in pregnancy - preparing for a healthy child

Chapter 6 Neurological disorders - SACD/MS-like presentation

Chapter 7 Autoimmune glandular disorders, with special reference to APS and hypoadrenalism

Chapter 8 Neuropsychiatric disorders, including dementia

Chapter 9 Vitamin B12 and cancer prevention

Bibliography and index

Appendices: Appendix 1 protocol for excluding B12 deficiency, and Appendix 2 protocol for diagnosing hypoadrenalism/ Addison's disease

Title page and Table of Contents


Part 1: Dr Joseph Chandy: journey to discovery. 2

Part 2: Ups and downs. 8

Part 3: Sharing the knowledge widely. 15

Importance of holistic care: Mother Teresa’s influence. 17

What B12 therapy means to our patients. 19

Chapter 1 Vitamin B12: a profile

1.1       Vitamin B12 characteristics. 25

1.2       Vitamin B12 - history of discovery. 31

1.3       Deficiency prevalence and manifestation. 34

1.4       Illness groups and conditions linked to B12 deficiency. 38

1.5       Common diagnoses that respond well to B12 supplementation. 41

Chapter 2 How to diagnose Vitamin B12 deficiency

Message from a patient to the world. 42

2.1       Background to diagnosis of vitamin B12 deficiency. 44

2.2       Wide-ranging effects of B12 deficiency. 51

2.3       Our diagnostic method. 54

Chapter 3 Treating B12 deficiency

3.1       Vitamin B12-treatment regimes. 67

3.2       A note on safety. 67

3.3       Different types of Vitamin B12. 68

3.4       When to start B12 therapy. 71

3.5       How much and how often?. 71

3.6       Dangers of withdrawing treatment 76

3.7       Body stores and daily losses. 76

3.8       How long will it take for symptoms to recover?  79

3.9       Reversing-out syndrome. 79

3.10     Other considerations. 80

3.11     Vitamin B12 as a prophylactic measure to avoid deficiency. 81

3.12     Shinwell Medical Practice Patient Surveys on vitamin B12 therapy. 81

Chapter 4 Megaloblastic anaemia - not the only way to diagnose B12 deficiency

4.1       B12 deficiency and haematopoiesis (formation of blood cells) 87

4.2       What is megaloblastic anaemia?. 87

4.3       Delays in diagnosis via the “Addisonian criteria”  90

4.4       The importance of early diagnosis. 95

4.5       Vitamin B12 interactions with folate. 97

4.6       Risk of other conditions and associated autoimmune disease. 99

Chapter 5 Vitamin B12 in pregnancy - preparing for a healthy child

5.1       Advance preparation for a healthy pregnancy. 103

5.2       Birth defect preventive programme: vitamin B12 supplementation. 104

5.3       Vitamin B12 and fertility. 104

5.4       Considerations during pregnancy: the myth of haemodilution. 106

5.5       Identifying the non-anaemic B12-deficient mother 107

5.6       Vegetarian/vegan mothers and vitamin B12 deficiency. 107

5.7       Neural tube defects: the roles of folic acid and vitamin B12. 108

5.8       Embryo and neonate B12-deficiency manifestation. 112

5.9       Clinical symptoms of vitamin B12 deficiency in infants and children. 113

5.10     Inheriting the genes for vitamin B12 deficiency. 115

Chapter 6 Neurological disorders - SACD/MS-like presentation

6.1       Vitamin B12 deficiency and neurological disorders. 132

6.2       SACD: a “forgotten” illness. 132

6.3       SACD: difficulty of diagnosis by traditional means  133

6.4       Examples of misdiagnosis of SACD.. 133

6.5       Misdiagnosis as MS (Multiple Sclerosis) 134

6.6       Comparison of symptoms: SACD and MS. 136

6.7       “Window of opportunity” for treatment 138

6.8       Patterns emerging from our cases. 138

6.9       Genetic link in MS. 139

Chapter 7 Autoimmune glandular disorders, with special reference to APS and hypoadrenalism

SECTION 1 Autoimmune glandular disorders and vitamin B12 deficiency. 163

7.1       Vitamin B12 deficiency – an underlying cause?  164

7.2       Need to screen for autoimmune glandular conditions in B12-deficient patients. 164

7.3       Autoimmune Polyglandular Syndrome. 164

7.4       Treatment of APS and importance of early detection. 166

7.5       Vitamin B12 – the link with autoimmunity. 167

7.6       Overview: glands, hormonal cycles and the HPA axis. 168

SECTION 2: APS component illnesses: Hypoadrenalism.. 170

7.7       Forms of hypoadrenalism.. 170

7.8       SECTION 3: Other APS component illnesses. 190

Chapter 8 Neuropsychiatric disorders, including dementia

8.1       Vitamin B12 deficiency and neuropsychiatric symptoms – an overview.. 196

8.2       Historic evidence. 196

8.3       Range of neuropsychiatric symptoms. 196

8.4       Vitamin B12 deficiency and the human brain. 197

8.5       Categories of neuropsychiatric symptoms. 198

8.6       Withdrawal of vitamin-B12 therapy may lead to psychosis. 199

8.7       What is dementia?. 200

8.8       The connection between vitamin B12 deficiency and dementia. 201

8.9       Links with other conditions. 204

8.10     Is dementia inherited?. 205

8.11     Nutrition and lifestyle. 205

8.12     Treating dementia and other neuropsychiatric conditions. 206

Chapter 9 Vitamin B12 and cancer prevention

9.1       Cancer worldwide prevalence. 210

9.2       Some causes of cancer 210

9.3       Cancer treatment 211

9.4       Cancer prevention. 213

9.5       Vitamin B12, folate and correct formation of DNA  216

9.6       Aberrant DNA methylation in cancer 217

9.7       Dual role of folate and folic acid in cancer development 217

9.8       Tissue-specific cancers and vitamin B12. 218

9.9       Critical time-windows in cancer prevention. 221

Are you B12 Deficient? Use our diagnstic calculator to find your diagnosis and how we can help you
Charity Events - View our calendar of events and see what is coming up for B12d
Success Stories - Read success stories on patients of Dr Chandy and other B12 Patients

B12d Charity Support Group Blog

  • 08

    NICE Guidelines for B12d published 6 March 2024 - Guidelines and our response

    After months (some would say years) of careful lobbying...

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  • 17

    Case studies from 2014 uploaded

    Way back before we thought of publishing a book, we cre...

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  • 04

    May 2020 Newsletter

    The newsletter is available as a PDF, with an article a...

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  • 23

    Coronavirus and meetings moved online

    Vitamin B12 is vital for the immune system.  This ...

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Susan gets very tired, which isn't much fun especially as she has so much to do. Here she tells her story.
New documentary out from Elissa Leonard in North America, featuring Sally Pacholok and many other internationally renowned experts.
Just the way it works for humans, oral B12 can make a world of a difference for your pet. My old cat Smudge chases the young cat again, climbs ladders (and climbs down herself), and is generally as fit as she was many years ago.
Donna, like so many women, wants to live a normal life. Vitamin B12 could give her that chance.
Frankie tells of how she suffered, the tests she had to endure until doctors worked out what was wrong, and what a difference it has made.
The definitive and original guide to B12 deficiency, Dr Chandy interviewed by Chris Jackson of UK BBC Inside Out Team broadcast 31 Oct 2008.
Dr Joseph Chandy explains symptoms and shows the restorative effect on one patient (other patients' families have asked that we edit out their stories unfortunately)
The Scottish Parliament discusses Pernicious Anaemia and vitamin B12 deficiency on Wednesday 7 March 2012.
This video is over 1 hour long and represents real political change - we are at last on our way.
Janette first appeared in the BBC InsideOut documentary in October 2006. Since then the NHS has forced her doctor to withdraw B12 replacement therapy on a number of occasions, and she tells of her struggles with having B12 and then having it taken away.
She has bravely agreed to be filmed without her usual wig, but her memory is playing up because it is so long since her last injection.
Julia found her eyesight going as her eyes refused to focus on the same things as each other. She's been for all sorts of tests and treatment, but now that she's on B12 replacement therapy she's starting to see an improvement.
Dr Chandy was nominated for the North East Local Heroes award. The interviewer was at first surprised - people don't get awards for doing what they are paid to do - but she persisted.