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Symptoms of pernicious anemia can vary, but common symptoms include: Depression and irritability Difficulty maintaining balance Fatigue and weakness Heart palpitations Loss of appetite Numbness or tingling in the hands and feet Pale skin Shortness of breath Weight loss Can I have pernicious anemia without having symptoms

Licensed Medical Professionals Administered by licensed medical professionals in a clinical IV therapy setting

It's very likely

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The Centers for Disease Control and Prevention (CDC) states that if a multi-dose vial has been opened or accessed (e.g., needle-punctured) the vial should be dated and discarded within 28 days unless the manufacturer specifies a different (shorter or longer) date for that opened vial