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Am J Physiol Endocrinol Metab 312(3):E175-E82 2017 PMC5374297 von Frankenberg AD, Marina A, Song X, Callahan HS, Kratz M, Utzschneider KM

10.1021/acs.accounts.7b00159 36 DasE

[20] Pernicious anemia may be present without a person experiencing symptoms at first, over time, feeling tired and weak, lightheadedness, dizziness, headaches, rapid or irregular heartbeat, breathlessness, glossitis (a sore red tongue), poor ability to exercise, low blood pressure, cold hands and feet, pale or yellow skin, easy bruising and bleeding, low-grade fevers, tremor, cold sensitivity, chest pain, upset stomach, nausea, loss of appetite, heartburn, weight loss, diarrhea, constipation, severe joint pain, feeling abnormal sensations including tingling or numbness to the fingers and toes ( pins and needles ), and tinnitus, may occur

The white blood cell count is usually moderately elevated, with a predominance of granulocytes