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Ongoing scientific scrutiny is a fundamental part of this process

Intrinsic factor deficiency causes pernicious anemia, which may be associated with subacute combined degeneration of the spinal cord

Just look at the history of people with ME (myalgic encephalomyelitis) or with Long-Covid, and how they have been ill-diagnosed and not well treated, and you realize how mediocre the specific evaluation of many people with unexplained symptoms may have been

Typical b12 deficiency symptoms include persistent fatigue, breathlessness, glossitis and pallor

"Unexpected high plasma cobalamin: proposal for a diagnostic strategy"