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Symptoms of B12 deficiency include: Weakness, fatigue and dizziness Heart palpitations Pallid skin Constipation, diarrhea and gassiness Vision loss Numbness or tingling in the extremities Depression and memory loss If you are a vegan or vegetarian and feel run down and fatigued, you may be B12 deficient

In another study 13 of patients with known pernicious anemia who had not received maintenance vitamin B 12 injections for months to years, the rise of methylmalonic acid and homocysteine levels was found to precede the decrease in serum vitamin B 12 and the decline in hematocrit