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Ibrahim ME, Chang C, Hu Y, Hogan SL, Mercke N, Gomez M, et al

The most common warning signs are: Fatigue Dizziness Weakness Nausea Vomiting Diarrhea Pale or yellowish skin Mood changes (depressed or irritable) Sore mouth and/or a swollen tongue Numbness and tingling in the extremities Difficulty walking or speaking like normal Memory impairment and/or forgetfulness Changes in cognition Diagnosis and treatment Because symptoms are not always present, providers usually choose a variety of blood tests to check for a B12 deficiency

Additionally, in order to eliminate bias, both investigators and participants should be blinded and remain unaware of whether a participant is receiving a placebo or treatment

PMC 8226782