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These include: - Fatigue - Irritability - Pale yellow tinge on the skin - Vision problems - Memory loss - Pins and needles or paraesthesia - Loss of physical co-ordination - Damage to parts of the nervous system

[1] Primary mechanisms: modulation of the nitric oxide (NO) system via upregulation of eNOS, activation of VEGFR2-Akt-eNOS signaling for angiogenesis, and enhancement of antioxidant defenses (HO-1 upregulation)

At this point, there is insufficient evidence to recommend B12 supplementation for fatigue beyond correcting a deficiency

A catch-all answer to these and other health troubles could lie in a therapeutic peptide called epitalon