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Symptoms develop gradually and may include: Hematological: Megaloblastic anemia, fatigue, weakness, pallor, shortness of breath, dizziness

Disulfide bonds between the constituent cysteine residues of proteins are important in conferring native structure to proteins

(5.7, 8.1, 8.3) Adverse Reactions/Side Effects The most common adverse reactions (incidence 20%) of pemetrexed for injection, when administered as a single agent are fatigue, nausea, and anorexia

A 12-week clinical trial showed subjects taking AOD-9604 (1 mg/d) lost an average of 2.6 kg, compared to 0.8 kg in the placebo group.

Several factors cause this: Lower stomach acid production [6] Less intrinsic factor [6] Interference from medications (especially proton pump inhibitors and metformin) [6] Atrophic gastritis affects 8-9% of adults over 65, which makes nutrient absorption even harder [7]

Beyond infancy symptoms are subtle and inconstant