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Low Vitamin B12 Levels: Symptoms and Causes On the other hand, low B12 levels (cobalamin deficiency) can lead to a range of symptoms, including: (1) Fatigue and weakness† Tingling or numbness in the hands and feet (neuropathy)† Memory issues, brain fog, and confusion† Pale or jaundiced skin† Shortness of breath and dizziness† Depending on the severity of the B12 deficiency, addressing it often requires dietary changes, high-dose oral supplements, or injections