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[DOI] [PMC free article] [PubMed] [Google Scholar] 6.Getahun D, Nash R, Flanders WD, et al

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Signs of deficiency The following symptoms may be a sign of B12 deficiency: extreme tiredness lack of energy pins and needles sensation muscle weakness depression and cognitive problems such as impaired memory, understanding and judgement A lack of B12 can lead to a raised level of the amino acid homocysteine in the blood which has been linked to heart disease