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Here are some signs you have PA: Early signs of pernicious anemia Fatigue (many people wake up tired despite getting enough sleep) Shortness of breath Feeling dizzy Loss of appetite Diarrhea or constipation Lightheadedness when standing up or moving around Pale or yellow skin (in people of European ancestry) Heartburn Swollen tongue Long-term signs of pernicious anemia Short-term memory loss Trouble with balance (for example, struggling to put on your pants or socks while youre standing) Burning feeling in your legs or feet that may get worse at night Depression Trouble focusing and confusion Cold hands and feet Hallucinations Eyesight problems Pernicious anemia tongue About 25% of people with pernicious anemia have symptoms on their tongues

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Whilst vitamin B12 toxicity is exceptionally rare, very high levels from supplements or injections have been associated with skin reactions such as acne-like eruptions

Once symptom improvement plateaus, you can try less frequent schedules and monitor your bodys response

Patients interested in fat loss, insulin resistance, or metabolic health should start with a medical review