[6] [25] At levels only slightly below normal, deficiency can result in fatigue, headaches, feeling faint, rapid breathing, pale skin, numbness or tingling, poor appetite, heartburn, poor balance, difficulty walking, poor reflexes, blurred vision, memory problems, depression, irritability, inattention, cognitive decline, dementia, and even psychosis
This has enabled deeper investigation into molecular mechanisms and biochemical regulatory processes
Diagnosis usually entails measuring serum levels of vitamin B12 or identifying elevated levels of methylmalonic acid and homocysteine
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Those following vegetarian or vegan diets may have lower dietary intake of B12