Anaemia Mukt Bharat is an ambitious programme for reducing the prevalence of anaemia among the most vulnerable of populations in the country; that is women and adolescent girls. The diagnosis of anaemia under the programme is epidemiological and deals with the most common causes of the condition that is a dietary deficiency of iron and also co-existing infections like helminthiasis. However, occasionally the primary care personnel are likely to come across complicated cases of anaemia due to not so uncommon causes such as vitamin B12 deficiency. Though it appears straightforward to diagnose and treat a case of megaloblastic anaemia, sometimes the investigation results can be misleading and often alarming even to a patient. The programmatic approach in such cases is rather tardy and not very gratifying to the physician. We present a case of pancytopenia during the COVID-19 period which presented unique challenges, however, managed with consistent follow-up and referral care along with dietary management of the condition which resulted in the alleviation of symptoms. The lessons learnt could be integrated into the programmatic approach to rarer conditions precipitating anaemia in the adolescent age group. This age group is susceptible to many issues associated with the transition to adulthood including dietary fads