Vitamin B12 in health and disease
Standard is weekly same-day dosing, but timing within that day matters significantly
Neurological symptoms are among the most clinically significant and may include: Tingling, numbness, or a 'pins and needles' sensation in the hands and feet Difficulty with balance and coordination (sensory ataxia) Memory problems, cognitive slowing, or confusion Mood changes, including low mood or irritability Haematological symptoms may include: Persistent fatigue and weakness Breathlessness on exertion Pallor or a slightly yellowish tinge to the skin A sore, inflamed tongue (glossitis) It is worth emphasising that neurological damage from B12 deficiency including subacute combined degeneration of the spinal cord can progress and become irreversible if treatment is delayed, even in cases where anaemia is absent
Retinopathy, neuropathy, and foot care: Standards of Care in Diabetes 2026
doi:10.1016/0895-4356(94)90117-1 Franco R, Schoneveld OJ, Pappa A, Panayiotidis MI