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Neurologic symptoms may include: Numbness or tingling (pins and needles feeling) in hands, feet, and legs Weakness or loss of muscle strength Difficulty concentrating Hallucinations Memory loss Depression Confusion Loss of balance Speech difficulty Increased irritability Causes of Pernicious Anemia The main cause of pernicious anemia is an autoimmune reaction that destroys stomach cells and prevents intrinsic factor production

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06 Missed dose Reported protocols typically skip a missed dose and resume at the next scheduled session rather than doubling up