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Complications of Left Untreated Untreated pernicious anemia can lead to severe complications such as: Neurological Damage: Permanent nerve damage and cognitive impairments

A seminal cost analysis published in Canadian Family Physician (2001) projected that switching patients from intramuscular B12 injections to oral supplements could save between $2.9 million and $17.6 million depending on the population studied with one Ontario analysis estimating $14.5 million in savings for 110,000 elderly patients

For example, breast-fed infants of women who follow strict vegetarian diets have very limited reserves of vitamin B12 and can develop a vitamin B12 deficiency within months of birth [7,16]