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A deficiency may lead to a wide range of symptoms, including: Ongoing fatigue or low energy Brain fog or difficulty concentrating Low mood or irritability Pale skin or a yellow tinge Tingling or numbness in the hands and feet Shortness of breath Dizziness or feeling faint Mouth ulcers or sore tongue Blurred vision Some of these symptoms may also be caused by iron deficiency

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Women tend to experience more gastrointestinal side effects at each dose level in clinical trial data, though the difference is not large enough to warrant a different escalation schedule

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There is evidence that treatment with B12 injections can help alleviate the condition, according to the research