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Neurological symptoms are among the most clinically significant and may include: Tingling, numbness, or a 'pins and needles' sensation in the hands and feet Difficulty with balance and coordination (sensory ataxia) Memory problems, cognitive slowing, or confusion Mood changes, including low mood or irritability Haematological symptoms may include: Persistent fatigue and weakness Breathlessness on exertion Pallor or a slightly yellowish tinge to the skin A sore, inflamed tongue (glossitis) It is worth emphasising that neurological damage from B12 deficiency including subacute combined degeneration of the spinal cord can progress and become irreversible if treatment is delayed, even in cases where anaemia is absent
They are on 50 units too
doi: 10.1186/s12974-019-1638-6 38 NizariSBasalayMChapmanPKorteNKorsakAChristieINet al
They also did not have active vitiligo that appeared in the last year
If INR shifts unexpectedly, communicate promptly with your anticoagulation clinic
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