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The symptoms are: Low energy Chronic fatigue Weakness Light-headedness Heart palpitations and shortness of breath Pale skin Dental problems, such as mouth sores and bleeding gums Sore red tongue Yellowing of the skin Mouth ulcers Constipation, diarrhoea, nausea, loss of appetite, or gas Nerve issues such as tingling or numbness, muscle weakness, and difficulty walking Joint pain Vision loss Mental illness, memory loss, or behavioural changes Poor concentration Dr Aravinda further noted that serious clinical symptoms like dementia, weariness, mood disruption, and megaloblastic anaemia can result from severe vitamin B12 insufficiency

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Evaluating potential ecotoxicological consequences on parasites transmission, reproduction, or survival is thus a complex issue (Khan and Thulin, 1991