What are the signs of low B12?
The signs of low B12 build slowly. They start with fatigue and pallor from anemia, then the nervous system, tingling hands and feet, unsteady walking, memory dulling, low mood, sometimes a sore smooth tongue. Nerve damage can arrive before anemia does.
Risk concentrates in vegans, older adults, metformin and long-term acid-blocker users, and anyone with gut absorption problems.
A blood test settles it, and treatment, tablets or injections depending on cause, reverses most symptoms if caught early; long-standing nerve damage forgives less. Persistent unexplained tingling deserves this test by name.
See a doctor promptly if
- Hemoglobin well below the normal range with breathlessness, chest pain, or dizziness on standing
- Potassium below 3.0 mmol/L or above 6.0 mmol/L. This needs same-day contact, not a routine appointment
- A sudden large rise in creatinine, or a new drop in eGFR, especially with reduced urine output
- Liver enzymes several times the upper limit with yellow eyes, dark urine, pale stools, or right upper abdominal pain
- Platelets under 50 x10^9/L, or a very high or very low white cell count with fever
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Answered by the AskDoc Medical Team · Medically reviewed under our Medical Director, MBBS · How we review
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