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Pernicious anemia occurs more commonly in people who already have diseases that are linked to immune-system abnormalities, such as Graves disease, hypothyroidism (under-functioning thyroid gland), thyroiditis (inflammation of the thyroid), vitiligo, and Addison's disease (adrenocortical insufficiency)

Individuals with B12 deficiency may experience disrupted sleep patterns, and B12 shots can help them regain healthy sleep routines, contributing to an overall healthier life

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(24) As you can see, anyone following a strict vegan diet may struggle to obtain adequate levels of vitamin B12 in their daily diet