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Permanent nerve damage from prolonged deficiency

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Signs and symptoms include: Generalized urticaria (hives) or widespread pruritic rash Angioedema affecting the face, lips, tongue, or throat Respiratory symptoms including wheezing, dyspnea, or throat tightness Gastrointestinal symptoms such as severe abdominal cramping, nausea, or vomiting (distinct from common GI side effects) Cardiovascular manifestations including tachycardia, hypotension, or dizziness Anaphylaxis represents the most severe form of allergic reaction and constitutes a medical emergency