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History [edit] Descriptions of deficiency effects [edit] Between 1849 and 1887, Thomas Addison described a case of pernicious anemia, William Osler and William Gardner first described a case of neuropathy, Hayem described large red cells in the peripheral blood in this condition, which he called "giant blood corpuscles" (now called macrocytes), Paul Ehrlich identified megaloblasts in the bone marrow, and Ludwig Lichtheim described a case of myelopathy

Along with medical treatments, particular attention should be paid to address the psychological factors associated with HS in children and adolescents by regularly monitoring patients mental health, as the disease can have devastating effects on mental and emotional well-being (54)

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Also avoid added sugar in beverages and snacks, highly processed foods, fast food, and alcohol, especially during dose titration