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Signs You May Be Low in Vitamin B12 Persistent tiredness or lack of energy Brain fog or poor concentration Low mood, irritability, or anxiety Pale skin or dark under-eye circles Frequent headaches or dizziness Pins and needles or numbness in hands and feet Weak immune response Difficulty sleeping A deficiency in B12 is particularly common among vegetarians, vegans, people with digestive disorders, or those with high-stress lifestyles

In the primary healthcare setting, the most commonly seen causes of vitamin B12 deficiency are related to abnormalities of digestion (atrophic gastritis, achlorhydria or the consequences of gastrectomy) or absorption (autoimmune pernicious anaemia, chronic pancreatitis, Crohns disease, the effect of medications that alter the mucosa of the ileum, or the consequences of surgical resection), and, to a lesser extent, a lack of exogenous supply

If you're unsure of how to do this put "Freedom of Information" into search box on CCG/GP surgery website

Using your fingers on the other side of the hand for balance and stability, slowly walk your thumb across the palm, pressing gently but firmly into the hand