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According to the American Autoimmune Related Diseases Association, symptoms of pernicious anemia in adults typically do not begin to show until after age 30

Serum B12 reflects the general amount of B12 stores and is a useful indicator of B12 status although it lacks sensitivity and specificity for diagnosing B12 deficiency (235, 236)
Indeed, regular injections can boost energy levels and help with weight loss and mood