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Signs and symptoms: Many common symptoms can be caused by vitamin B12 deficiency, including weakness, tiredness, lightheadedness, heart palpitations, shortness of breath, pallor (pale skin), diarrhea, decreased appetite, nerve problems like numbness or tingling, visual changes and psycho-emotional problems like depression, memory loss or behavioral changes
Also, the concomitant use of topiramate with any other drug producing metabolic acidosis, or potentially in patients on a ketogenic diet, may create a physiological environment that increases the risk of kidney stone formation, and should therefore be avoided
Mangoni, M
B12 injections are also used to treat people with malabsorption (gastrointestinal conditions that prevent proper absorption of B12 from the gut), for example, people with atrophic gastritis (stomach inflammation) and intrinsic factor deficiency (pernicious anemia) or those who have undergone surgical procedures such as gastrectomy or small bowel resection (stomach or intestine removed), autoimmune diseases, etc
