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A deficiency can erode this coating and cause neuropathy (tingling, numbness, or pain in the hands and feet)

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However, full effects are usually felt after your third dose

25 Patients diagnosed with vitamin B 12 deficiency whose history and physical examination do not suggest an obvious dietary or malabsorptive etiology should be tested for pernicious anemia with anti-intrinsic factor antibodies (positive predictive value = 95%), particularly if other autoimmune disorders are present