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Common signs of B12 deficiency include: Persistent fatigue that doesnt improve with rest Difficulty concentrating or brain fog Mood changes, including low mood or irritability Tingling or numbness in the hands and feet Weakness or shortness of breath with normal activity Pale skin or a smooth, swollen tongue B12 deficiency can develop silently for months before symptoms become noticeable, which is why its frequently missed

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Alternatively, patient advocacy and congressional pressure might create new access pathways