Haematological symptoms often appear first and include: Fatigue and weakness due to anaemia Pallor (pale skin) Shortness of breath, particularly on exertion Heart palpitations Glossitis (sore, red tongue) Mouth ulcers Neurological manifestations can be particularly concerning and may include: Paraesthesia (pins and needles) in hands and feet Peripheral neuropathy causing numbness or altered sensation Difficulty walking or balance problems (ataxia) Memory problems and cognitive difficulties Mood changes, including depression or irritability Rare optic neuropathy in severe cases Other symptoms that may occur include: Digestive disturbances Loss of appetite and weight loss Generalised weakness It is crucial to note that neurological symptoms can occur even in the absence of anaemia, and you should contact your GP urgently if you experience persistent paraesthesia, balance problems, memory difficulties, or unexplained neurological symptoms

This work was supported by grants from the Postgraduate Education Innovation program of Shanxi Province (2024SJ155, YW), the central government guiding local funds for scientific and technological development (YDZJSX20231A062, CX), scientific and technological achievements transformation guidance project of Shanxi Province (202204021301067, CX), the National Natural Science Foundation of China (82350710800, 82374470, JX), National Key R&D Program of China (2024YFA0919200, JX), Shenzhen Science and Technology Program (KCXFZ20240903094059020, JX), and Shenzhen Medical Research Fund (B2302005, JX)
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