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[6] If this happens, vitamin B 12 deficiency may result in sense loss, loss of sensation in the feet, difficulty walking, poor balance, blurred vision, changes in reflexes, muscle weakness, decreased smell and taste, decreased level of consciousness, mood changes, memory loss, depression, irritability, clumsiness, disorientation, dementia and, in severe cases, psychosis

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You can see the temporary spike during dose transitions and understand that it will resolve as the new steady state establishes itself over the following weeks