Haematological symptoms often appear first and include: Fatigue and weakness due to anaemia Pallor (pale skin) Shortness of breath, particularly on exertion Heart palpitations Glossitis (sore, red tongue) Mouth ulcers Neurological manifestations can be particularly concerning and may include: Paraesthesia (pins and needles) in hands and feet Peripheral neuropathy causing numbness or altered sensation Difficulty walking or balance problems (ataxia) Memory problems and cognitive difficulties Mood changes, including depression or irritability Rare optic neuropathy in severe cases Other symptoms that may occur include: Digestive disturbances Loss of appetite and weight loss Generalised weakness It is crucial to note that neurological symptoms can occur even in the absence of anaemia, and you should contact your GP urgently if you experience persistent paraesthesia, balance problems, memory difficulties, or unexplained neurological symptoms
It must then bind to intrinsic factor for absorption in the intestines
It identifies the subset of patients who truly benefit from supplementation
In facility settings, the physician bills the E/M only
They also help the nervous system function properly
While individual hypersensitivity cannot be entirely eliminated, the clinical trial evidence is highly reassuring
