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Common symptoms of a vitamin B12 deficiency include: Tiredness Lethargy Feeling faint Breathlessness Less common symptoms include: Headaches Heart palpitations Altered taste Loss of appetite Ringing in the ears (tinnitus) Looking pale Sore mouth and tongue If it is left untreated you can end up with longer term problems including: Psychological problems such as depression, confusion, memory problems Nerve problems such as numbness, pins and needles, vision changes and unsteadiness A blood test can indicate if you have a B12 deficiency

doi: 10.1093/carcin/22.12.1903

10.1099/mic.0.064139-0 Microbiology (Reading)

Where serum B12 results are borderline or do not fit the clinical picture, further tests such as active B12 (holotranscobalamin), methylmalonic acid, or homocysteine may be helpful