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Possible symptoms and risk factors of vitamin B12 deficiency may include: red blood cell conditions (anemia) issues with red, white, and platelet blood cells (pancytopenia) persistent fatigue skin sensations like tingling, numbness, or burning (paresthesia) erectile dysfunction bowel or urinary incontinence depression a higher chance of Alzheimer’s disease episodes of mania (euphoria) and psychosis Causes and risks of high vitamin B12 It is unlikely that you’ll develop high levels of vitamin B12 through diet alone