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2 Table 2 Clinical Manifestations of Vitamin B12 Deficiency Maternal vitamin B 12 deficiency during pregnancy or while breastfeeding may lead to neural tube defects, developmental delay, failure to thrive, hypotonia, ataxia, and anemia

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14 Signs You Should Get a Vitamin B12 Injection 1

Neurological deterioration requires investigation

Most nausea and vomiting occur during dose increases rather than at stable doses

That can slow how the dose is used and is a known issue, particularly in women and larger patients where there is more tissue to pass through