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Clinical presenting features of the condition include those relating to anaemia (e.g., pallor, weakness, and fatigue), gastro-intestinal symptoms (e.g., epigastric pain and glossitis), neurological symptoms (e.g., from numbness of extremities and impaired proprioception in subacute combined degeneration of the spinal cord to severe developmental delay, epilepsy, and coma in inherited intracellular cobalamin defects), psychiatric disturbances and neural tube defects in the newborn of a deficient mother (Molloy et al., 2009)

Often the explanation is simple and benign, often iatrogenic, meaning it comes from B12 the patient is taking or being given

"Some people are deficient and feel a lot better when given a shot, but just to pep you up, there's no study that says it's helpful." B12 is created by bacteria, including those living in the digestive tract

This pain is often described as a dull ache that originates deep in the shoulder

A lack of B12 can affect everything from physical energy to mental health

A week later I developed a rash and my injection site was hot and itched like crazy