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Beyond hair changes, watch for these warning signs: Energy and Physical Symptoms: Persistent fatigue and weakness Breathlessness Pale or yellowish skin Heart palpitations Dizziness or lightheadedness Cold hands and feet Neurological Symptoms: Tingling or numbness in hands and feet (pins and needles) Difficulty walking or balance problems Muscle weakness Cognitive and Mood Symptoms: Brain fog or difficulty concentrating Memory problems Mood changes, irritability, or depression Confusion Other Signs: Sore, red tongue (glossitis) Mouth ulcers Changes in vision Loss of appetite Hair and Appearance Changes: Increased hair shedding Hair thinning Premature greying Brittle hair Dry skin Weak, ridged nails If youre experiencing several of these symptoms alongside hair changes, B12 deficiency could be a contributing factor worth investigating
Patients should be informed of the pros and cons of oral versus parenteral therapy, and regardless of the form of treatment, those with pernicious anemia or malabsorption should be reminded of the need for lifelong replacement
Increased serum vitamin B12 levels are associated with adult-onset Stills disease with reactive macrophage activation syndrome
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