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Shortness of breath and dizziness : This can be due to the decrease in red blood cells, because one of the other things vitamin B12 does is help with the production of red blood cells

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Commercial insurers implement step therapy requirements forcing patients to fail lower-cost alternatives before approving expensive medications

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)