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1 Asymptomatic autoimmune gastritis likely precedes gastric atrophy by 10 to 20 years, followed by the onset of iron-deficiency anemia that occurs as early as 20 years before vitamin B 12 deficiency pernicious anemia

You need a prescription to obtain a B12 injection, but they can be safely administered by a doctor or even at home

But occupational causes, such as repetitive manual labor, are more common

Rodig SJ, Shapiro GI

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