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Common symptoms include: Persistent fatigue and weakness , despite adequate sleep Brain fog and difficulty concentrating Numbness or tingling in hands and feet, an early sign of neuropathy Pale or jaundiced skin Shortness of breath and heart palpitations Megaloblastic anemia , meaning enlarged, abnormally shaped red blood cells Mood changes , depression, or memory issues Glossitis , an inflamed, swollen tongue If you experience several of these symptoms, consult a healthcare provider and request a serum B12 blood test before self supplementing