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24 Table 3 Estimated Sensitivity and Specificity of Serum Laboratory Tests for Vitamin B12 Deficiency Pernicious anemia refers to one of the hematologic manifestations of chronic auto-immune gastritis, in which the immune system targets the parietal cells of the stomach or intrinsic factor itself, leading to decreased absorption of vitamin B 12

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When to See Your GP About Nerve Pain and B12 Levels You should arrange to see your GP if you experience: Persistent tingling, numbness, or burning sensations in your hands or feet Unexplained weakness or difficulty walking Balance problems or frequent falls Memory problems or cognitive changes Persistent fatigue accompanied by neurological symptoms Symptoms of nerve pain if you have risk factors for B12 deficiency Recent recreational nitrous oxide use with neurological symptoms Your GP will typically begin with a thorough clinical history and examination, followed by blood tests to measure serum B12 levels