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Symptoms of B12 Deficiency The symptoms of vitamin B12 deficiency include a mixture of the physical symptoms associated with peripheral neuropathy, as well as cognitive issues: Physical Symptoms Peripheral Neuropathy experiencing unpleasant sensations in the extremities (the hands, arms, legs and feet) due to nerve damage, such as those listed above Despite feeling the minor irritating phenomenon of pins and needles, persistently feeling the sensation may suggest that you have nerve damage, which should be taken seriously Issues with your eyesight, such as visual disturbances or impairments Experiencing paralysis in areas such as the extremities can suggest that nerve damage has become severe, so medical intervention should be sought as soon as possible