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Doctors dont check B12 levels routinely, but they may do so if a patient reports symptoms such as weakness, fatigue, tingling in the extremities (neuropathy), or cognitive changes

Clinical signs of B12 deficiency include nausea, vomiting, loss of appetite, poor absorption of food (malabsorption syndrome), constipation, gas, weight loss, fatigue, lethargy, abdominal pain, and diarrhea

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