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The NHS symptoms list groups them into general anaemia symptoms (tiredness, breathlessness, headaches, loss of appetite, weight loss) and neurological signs (peripheral neuropathy, balance problems, depression, memory and concentration changes, sometimes mood changes or psychosis in advanced cases)

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Doctors must watch patients closely to adjust doses and handle any side effects

Unfortunately, some patients have difficulty absorbing an adequate amount of vitamin 12 because they do not produce enough stomach acid due to a condition called autoimmune atrophic gastritis which can cause a deficiency of vitamin B12