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In contrast, in severe infections such as bacteremia and meningitis, the pneumococcus must endure completely anaerobic conditions, with 0% oxygen present in the bloodstream and cerebrospinal fluid

Some of these problems can also occur if you have a deficiency in vitamin B12 or folate, but do not have anaemia. There are many journals on this 2012 Misdiagnosed vitamin B12 deficiency a challenge to be confronted by use of modern screening markers (.but its absence does not rule out B12 deficiency and it is not a specific marker as using it solely would miss 84 percent cases

Discontinue use if irritation persists

10.1016/j.freeradbiomed.2022.01.020 8