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The take-home is that even in well-managed cohorts on daily oral vitamin B12, a meaningful percentage of patients still end up deficient

Symptoms of vitamin B12 and folic acid deficiency anemia include: Shortness of breath Headache Indigestion Loss of appetite Heart palpitations Vision problems Feeling weak or tired Diarrhea Pain or redness of the tongue, sometimes with mouth sores Problems with memory, comprehension, and judgment (cognitive changes) Some of these symptoms may also occur in people who are deficient in vitamin B12 or folic acid but are not anemic

Seek medical advice if symptoms persist or worsen

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