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A deficiency of vitamin B12 can also cause shortness of breath or heart palpitations, as well as gastrointestinal symptoms including constipation, diarrhea, appetite loss, or gas

For context on SAMe and related evidence limits, see the NIH NCCIH resource S-Adenosyl-L-Methionine (SAMe): In Depth

Your brain and nervous systems are most affected, giving rise to symptoms such as fatigue, confusion, depression, loss of balance, and even hallucinations

B12 Injections in Cresskill, NJ Fatigue that lingers through the afternoon, mental fog during meetings, and sluggish recovery after workouts can signal a vitamin B12 deficiency