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Patients may experience: Persistent fatigue and weakness Breathlessness on exertion Pallor or a slightly yellowish tinge to the skin Heart palpitations Neurological symptoms are of particular clinical concern, as nerve damage caused by prolonged B12 deficiency can be irreversible if not treated promptly

The use of anti-infective agents or pyrimethamine may invalidate diagnostic assays for folic acid and vitamin B12

have or have had mental health problems such as depression or thoughts of suicide

Vitamin B12 is instrumental in the creation of new red blood cells and helps keep the nervous system functioning properly