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Because of the increased risk, today all vegan associations encourage vegans to take B12 in the form of fortified products, supplements or algae

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

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

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