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Common signs of a B12 deficiency include: Fatigue Weakness Pale skin Poor coordination Heart palpitations Loss of appetite Unexplained weight loss A B12 deficiency can also contribute to mental health issues like depression and cognitive issues like confusion and poor memory

Shared decision making Use shared decision making to establish a long term frequency of B 12 injections for each patient and teach them how to self-inject.80 How cost effective is B 12