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Because diagnosis can be delayed, veterinarians often begin supplementing B12 empirically when suspicion is strong as excess B12 poses minimal risk and is safely excreted if unnecessary

Beyond systemic symptoms, vitamin B12 deficiency is also associated with a range of oral manifestations, including burning mouth syndrome, recurrent aphthous ulcers, mucosal inflammation, and trigeminal nerve-related pain, which are often underdiagnosed or misattributed to other conditions (Bao et al., 2021

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What is largely agreed on, however, is that B12 deficiency can reduce energy levels and therefore make it harder to stay active and maintain a healthy weight