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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

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Adverse reactions after a B12 injection may include: A feeling of tightness in the chest Anaphylaxis (difficulty breathing or swallowing) Chest pain Congestive heart failure Heart palpitations Pulmonary edema Rapid heartbeat (tachycardia) Shortness of breath Vascular thrombosis Musculoskeletal Effects Your musculoskeletal system makes up your bones, tendons, cartilage, and connective tissues

Delay in treatment may prevent direct repair from being possible