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Here are some of the signs of B12 deficiency to look out for: Numbness, tingling, or a pins and needles feeling in the hands or feet (even if slight or minor) Falling or losing your footing more than usual or without reason Not being able to stay balanced Stiff muscles Vision changes Symptoms of psychosis (e.g., hallucinations, paranoia, disorganized thoughts, or schizophrenia-like symptoms) Severe or unusual tiredness Memory issues Sometimes, these symptoms can develop gradually

European Journal of Dermatology

As these signs and symptoms are nonspecific and often are not present at all, the initial suspicion of ID usually comes from the laboratory, with microcytic anemia or normocytic anemia, triggering a more definitive workup