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Sometimes symptoms can take years to show up as a deficiency, these symptoms include *Lack of energy *Muscle weakness *Extreme fatigue or tiredness *Yellow eyes *Pale or slightly yellow tinge to skin tone *Pin and needles (paraesthesia) *Shortness of breath and dizziness *Disturbed vision *Sore and or red tongue *Depression *Mouth ulcers *Psychological problems *Changes in mobility *Memory loss and understanding problems Vitamin B12 deficiency can be easily avoided, many people are becoming new to a vegan or vegetarian diet and are unaware of the need to combine sources of plant proteins

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doi:10.1016/S0076-6879(71)18006-8

Its use outside these approved indications is considered off-label