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In the absence of B12, the body can have difficulty producing healthy red blood cells, causing anemia, fatigue, and neurological symptoms including numbness or other cognitive problems

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Conclusion Whilst severe B12 deficiency has a clear clinical picture with characteristic haematological and/or neurological features, establishing mild or borderline deficiency can be problematic as serum levels are maintained at the expense of tissue concentrations, and therefore serum levels of B12 may be in the low normal or borderline range despite a deficiency

Successively the scenario was enriched by several molecular players that belong to redox-sensitive factors such as the Bcl-2 family (Kowaltowski and Fiskum, 2005