Title: Vitamin B12 Deficiency: Part 2<br/>Author: Jon Mark Hirshon<br/><a href='http://umem.org/profiles/faculty/96/'>[Click to email author]</a><hr/><p>
        Vitamin B12 deficiency can cause significant disease, including severe neurologic problems. However, patient presentations can vary greatly.</p>
<p>
        Signs and symptoms can include:</p>
<ul>
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                Constitutional symptoms: fatigue, lack of energy, lightheadedness, loss of appetite</li>
        <li>
                Gastrointestinal problems: diarrhea or constipation</li>
        <li>
                Cardiovascular: shortness of breath, dyspnea on exertion, tachycardia, CHF</li>
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                Oral lesions: swollen, red tongue (glossitis) or bleeding gums</li>
        <li>
                Problems concentrating</li>
</ul>
<p>
        Prolonged B12 deficiency can lead to significant neurologic complications, frequently related to the spinal cord, and can include:</p>
<ul>
        <li>
                Mild impairment to dementia</li>
        <li>
                Depression, psychosis</li>
        <li>
                Loss of balance, limb weakness, ataxia</li>
        <li>
                Peripheral neuropathy (numbness and tingling of hands and feet)</li>
</ul>