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If you have some of those symptoms especially if you have a low red blood cell count you should talk to your doctor about further blood tests for vitamin B12

As fat cells accumulate, this can create a worsened, uneven surface

[1] [2] B12 functions as a cofactor in cellular metabolism, participating in the conversion of homocysteine to methionine and the metabolism of methylmalonic acid, both crucial for energy production
However, severe or prolonged deficiency may cause permanent follicle damage
