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This "paradoxical response" (where treatment temporarily makes symptoms worse) includes: Numbness and tingling Shooting pains Joint pain Increased sensitivity Temporary inflammation (swelling and irritation) While these symptoms generally indicate that treatment is working (as nerves begin to repair themselves), they can be distressing for patients and may require additional treatment for comfort

Those with a vitamin B12 deficiency usually develop a fault when they stop taking B12 supplements

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And the position of the Pernicious Anaemia Society has always been that PA is more than just B12 deficiency