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Warning Signs of B12 Deficiency Symptoms That Signal B12 Deficiency Fatigue and weakness — megaloblastic anemia reduces oxygen transport throughout the body Cognitive changes — difficulty concentrating, reasoning, or memory loss from nerve cell impairment Oral issues — swollen, red tongue (glossitis) or burning mouth sensation Mood changes — depression and irritability linked to neurotransmitter disruption Tingling and numbness — pins-and-needles sensation in extremities progressing upward from toes and fingers Balance problems — difficulty walking or maintaining steadiness as neuropathy progresses Recognizing Signs of Peripheral Neuropathy A specific nutrient shortfall can disrupt the very insulation that protects our nerve pathways