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[4] Scientific References Frequently Asked Questions Can vitamin B12 supplements cause stomach pain

This impairment of DNA synthesis affects the rapidly dividing cells of the bone marrow earlier than other cells, resulting in the production of large, immature, hemoglobin-poor red blood cells (macrocytosis), as well as effects on white blood cells, including abnormal (hypersegmented) neutrophils and reduced overall cell counts (pancytopenia)

A deficiency in B12 can disrupt this process, leading to anemia, impaired red blood cell production and even nerve damage[7]