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However, long-term use of steroids should be avoided due to potential side effects

[20] Pernicious anemia may be present without a person experiencing symptoms at first, over time, feeling tired and weak, lightheadedness, dizziness, headaches, rapid or irregular heartbeat, breathlessness, glossitis (a sore red tongue), poor ability to exercise, low blood pressure, cold hands and feet, pale or yellow skin, easy bruising and bleeding, low-grade fevers, tremor, cold sensitivity, chest pain, upset stomach, nausea, loss of appetite, heartburn, weight loss, diarrhea, constipation, severe joint pain, feeling abnormal sensations including tingling or numbness to the fingers and toes ( pins and needles ), and tinnitus, may occur

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R., Harkness, R

Researchers continue to investigate how this signaling influences gene expression, cellular adaptation, and the maintenance of normal physiological function during periods of metabolic and environmental stress