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On the other hand, if a vitamin B12 deficiency does occur, it is associated with several undesirable health risks, some of which are as follows: shortness of breath heart palpitations tingling or numbness in the extremities poor balance mood changes incontinence insomnia loss of concentration poor memory chronic fatigue Those who smoke cigarettes, consume excessive amounts of alcohol, or adhere to a vegetarian or vegan diet are at a greater risk of acquiring a nutritional deficiency than younger adults

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Pharmacy and Therapeutics, 36(5), 255262