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The following approach may be reasonable for most patients

doi: 10.1271/bbb.70.926

Symptoms of vitamin B12 deficiency: extreme tiredness a lack of energy pins and needles a sore and red tongue mouth ulcers muscle weakness problems with your vision psychological problems, which can range from mild depression or anxiety to confusion and dementia problems with memory, understanding and judgement Causes of a vitamin B12 deficiency: pernicious anaemia a lack of these vitamins in your diet medicine certain medicines, including anticonvulsants and proton pump inhibitors (PPIs), can affect how much of these vitamins your body absorbs

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