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Common B12 deficiency symptoms include fatigue, anxiety, depression, poor memory, confusion, brain fog, tingling or numbness in the extremities, zings or zapping feelings in the extremities, anemia, shortness of breath, muscle weakness, irritability, tender calves, pale complexion and more

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Use of certain medications that may interact with B12 or choline metabolism (e.g., metformin, proton pump inhibitors, or anticholinergic drugs)