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Symptoms of a B12 deficiency include: Excessive fatigue Nerve problems (pain or abnormal sensations like numbness or tingling) Glossitis (tongue inflammation) Low numbers of white blood cells and red blood cells Vitamin B12 deficiency can be diagnosed with a blood test

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[12] Gastric acid-suppressing agents (proton-pump inhibitors and H-receptor antagonists) diminish dietary B12 liberation from protein complexes, a pharmacodynamic interaction that can exacerbate underlying deficiency