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That said, signs or symptoms that you may be low in vitamin B12 include: fatigue pale skin headaches symptoms of depression stomach issues difficulty focusing or concentrating pain or inflammation in the mouth or on the tongue burning or pins and needles feeling in your hands or feet muscle cramps vision changes Learn more: Signs and symptoms of B12 deficiency

Advanced liver disease may further complicate B12 status through altered binding proteins and reduced storage capacity

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This is a permanent treatment that requires careful consideration

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Notably, the results of fecal microbiota transplantation from PPI-administered mice to germ-free mice demonstrated that the intestinal flora is closely related to variations in intestinal permeability