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Megaloblastic anemia, in which red blood cells are larger than normal and smaller in amount Pernicious anemia, a type of anemia caused by lack of intrinsic factor Numbness and tingling in the hands and feet Dementia Depression Seizures Fatigue Sore mouth or tongue Palpitations Pale skin Weight loss Infertility Some of these side effects, particularly nervous system side effects and psychiatric problems, can be irreversible if not treated promptly

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