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Some people may experience symptoms such as fatigue, weakness, pale skin, numbness or tingling in the hands and feet, balance problems, memory concerns, or mouth soreness

Liz Hansen, pediatrician at Emplify Health in Onalaska, said she was in her second year of residency as a doctor when the vaccine was approved 20 years ago

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Other factors which can cause Pernicious Anemia and/or low B12 besides hypothyroidism Pancreatic insufficiency (when the pancreas is making le ss digestive enzymes) Gastritis (bacterial-caused inflammation which weakens the stomach lining) Stomach Removal (whether partial from Bariatric Surgery, or complete removal) Stomach cancer Active mutation of the Q5R intrinsic factor gene, plus other genes Low levels of folate aka B9 Symptoms of Pernicious Anemia From : The symptoms of pernicious anemia may include weakness, fatigue, an upset stomach, an abnormally rapid heartbeat (tachycardia), and/or chest pains