Numb : Part 2

A 60 year old man presented with numbness of both feet for 2 months, and was found to have isolated peripheral neuropathy secondary to underlying vitamin B12 deficiency.

He was diagnosed with type 2 diabetes mellitus 6 years ago, which is well controlled on Metformin alone. His medical history is otherwise normal.

He takes a mixed diet, and is on no other medications. A full blood count, blood film, iron studies, reticulocyte count and folate levels are all normal.

Select Relevant Investigations
Anti-IF & Anti-parietal cell Abs


Anti-intrinsic factor antibodies: negative
Anti-parietal cell antibodies: negative


A colonoscopy will be arranged next week.
INR & Vitamin D


INR: 1.0 (1 - 1.3)
Vitamin D: 50 pg/mL (24 - 65)
Anti-endomysial Abs


Anti-endomysial antibodies (IgA): negative

Select Relevant Management
Gluten Free Diet
Stop Metformin
Vit-B12 Supplementation