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The main symptoms include: Extreme tiredness Lack of energy Red or sore tongue or mouth Pale skin Changes in mood Changes in movement and balance Feeling pins and needles in arms and feet Reasons for vitamin b12 deficiency Vitamin b12 deficiency is caused mainly by two reasons

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Progressive hypotension was described following a second intravenous injection in some cases

Your body may recognize peptides as foreign and produce antibodies to fight them, or trigger autoimmune responses

Diffuse hyperpigmentation and gingival darkening were reported and reportedly recurred after re-exposure