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Neurological symptoms often develop gradually and may include: Paraesthesia : tingling or 'pins and needles' sensations, typically starting in the feet and hands Numbness : reduced sensation in the extremities, which may affect balance and coordination Burning pain : particularly in the feet, often worse at night Weakness : muscle weakness and difficulty walking Balance problems : unsteady gait and increased fall risk due to proprioceptive impairment Cognitive changes : memory problems, confusion, difficulty concentrating, and mood disturbances Haematological signs may accompany neurological symptoms and include fatigue, weakness, pallor, and shortness of breath due to megaloblastic anaemia

Another important gastric secreted protein is pepsinogen, which is cleaved by the HCl into pepsin, an enzyme that assists in the digestion of dietary proteins

Daily tasks may feel easier, and afternoon crashes may lessen

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The injections also often include other vitamins to promote a faster metabolism, increased energy, and a healthier heart