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This may increase inflammation and bacterial activity

Pernicious anemia is an autoimmune condition

Common side effects may include: Nausea or stomach upset, particularly when starting treatment Headaches, usually mild to moderate Breast tenderness or swelling Mood changes, such as feeling emotional or irritable Bloating due to mild fluid retention Temporary changes in libido If side effects are severe or do not settle, you should seek advice from a pharmacist or GP