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Keep in mind that the clinical manifestations of vitamin B12 deficiency differ depending on the degree and duration of deficiency, but some of the most common symptoms of a B12 deficiency include 4 : Anemia Chronic fatigue Shortness of breath Heart palpitations Pallor Skin hyperpigmentation Glossitis Infertility Osteoporosis Sensory loss Abnormal balance or reflexes Cognitive impairment Memory loss Older adults are at a higher risk for vitamin B12 deficiency, as are those on a vegetarian or vegan diet, as dietary B12 is found in animal products

It must be distinguished between a limited EP damage with relatively stable fragments, closed fracture lines or small defects, which result in no or a limited loss of nucleus tissue (injury type B2), from large defect with a virtual complete loss of NP tissue into the vertebral bone (type B3)

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Two patients (18.2 %) with a history of gastrectomy and 5 patients (45.5 %) without a history of gastrectomy had normal oral mucosa without erythema and depapillation of the tongue, or angular cheilitis ( P = 0.361) (Figs