Ingredients Maltodextrin, Bulking Agent: Microcrystalline Cellulose, Vitamin C (Ascorbic Acid [Hydroxypropylmethylcellulose & Tartaric Acid]), Magnesium Oxide, L-Carnitine Tartrate, Inositol (Carrier: Acacia Gum) Vitamin E (D-Alpha Tocopheryl Acid Succinate) (from Soya ), Maca Extract, Zinc Sulphate, Tablet Coating: (Hydroxypropylmethylcellulose, Glycerin, Colours [Iron Oxides]), Crosslinked Cellulose Gum, Pine Bark Extract, Anti-Caking Agents: Stearic Acid, Magnesium Stearate & Silicon Dioxide, Thiamin (Vitamin B1 as Mononitrate [Carrier: Hydroxypropylmethylcellulose]), Niacin (as Nicotinamide), Ferrous Fumarate, Citrus Bioflavonoids, Pantothenic Acid (as Calcium Salt), Vitamin B6 (Pyridoxine HCl), L-Arginine, Vitamin A (as Acetate [Carriers: Acacia, Starch, Maltodextrin, Antioxidants: DL-Alpha Tocopherol]), Vitamin D3 (Cholecalciferol [Carriers: Acacia, Sucrose, Corn Starch, Medium Chain Triglycerides, Antioxidant: DL-Alpha Tocopherol]), Siberian Ginseng Extract, Riboflavin, Octacosanol (Rice Bran), Copper Sulphate, L-Glutathione, Coenzyme Q10 (CoQ10), Manganese Sulphate, Lycopene Extract, Folic Acid (as Pteroylmonoglutamic Acid), Sodium Selenate, Chromium Trichloride, Biotin, Vitamin B12 (Cyanocobalamin)

Van Assche G, Lewis JD, Lichtenstein GR, et al
These occur because vitamin B12 is essential for maintaining the protective sheath around nerves
Early pernicious anemia symptoms are mild so mild that some people simply learn to live with feeling tired, lightheaded or breathless