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Without enough B12, red blood cells can become large and irregular (megaloblastic anemia), which reduces their ability to carry oxygen efficiently

This work was supported by grants from the Hainan Province Clinical Medical Center (QWYH202175), the Scientific Research Project of Hainan Health Committee (21A200115), the Research and Cultivation Fund of Hainan Medical University (HYPY2020015), the Specific Research Fund of The Innovation Platform for Academicians of Hainan Province (YSPTZX202311), the Natural Science Foundation of Hainan Province (820RC771), and the Key R&D Projects of Hainan Province (ZDYF2022SHFZ074)