Anaemia caused by vitamin B,2 deficiency, needed for the production of red blood cells. Vitamin B,: can be absorbed from food only with the assistance of a substance found in the gastric juices, and deficiency is usually caused by an inadequate quantity of this substance in the stomach as a result of chronic inflammation or surgical removal of a large part of the stomach. Vitamin B12 is also needed in the nervous system, and so a shortage not only produces symptoms of anaemia (such as fatigue, paleness, palpitations and giddiness), but also the condition of the nervous system may cause tingling or a dead feeling in the hands and feet, making walking more difficult. A specific symptom of pernicious anaemia, often the first, is smoothness of the tongue associated with pain on contact with acid food. Treatment is by vitamin B,2 injections.