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Vegetarian sources of B12 include chlorella, nori, nutritional yeast and certain mushrooms, but many vegans and vegetarians have insufficient levels of B12 because its not widely found in plants. According to Mullane, not getting enough B12 can result in issues like anaemia, fatigue and more intense symptoms including shortness of breath, palpitations, pale skin, muscle weakness, numbness and tingling in hands or feet, blurred vision and memory loss

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The resulting elevated concentrations of homocysteine and MMA are often found in patients with low serum vitamin B 12 and can usually be lowered with successful vitamin B 12 replacement therapy