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This occurs in conditions such as pernicious anemia, an autoimmune condition that affects the production of intrinsic factor, which is necessary for the absorption of B12 in the small intestine

In severe cases, the body may struggle to absorb enough of the vitamin from oral sources leading to continued symptoms of deficiency

Symptoms of vitamin B12 deficiency: extreme tiredness a lack of energy pins and needles a sore and red tongue mouth ulcers muscle weakness problems with your vision psychological problems, which can range from mild depression or anxiety to confusion and dementia problems with memory, understanding and judgement Causes of a vitamin B12 deficiency: pernicious anaemia a lack of these vitamins in your diet medicine certain medicines, including anticonvulsants and proton pump inhibitors (PPIs), can affect how much of these vitamins your body absorbs