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[1] [4] When B12 is deficient, myelin production is impaired, leading to demyelinationthe breakdown of this protective sheathwhich results in abnormal nerve signalling perceived as pain, tingling, or numbness

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According to the Mayo Clinic, parenteral vitamin B12 therapy is clinically indicated for treating deficiency caused by pernicious anemia, gastrointestinal disorders such as tropical sprue, and conditions resulting in malabsorption like pancreatic insufficiency