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In addition, B12 deficiency-associated fatigue is often accompanied by other symptoms such as numbness and tingling, cognitive impairment (memory and concentration problems), mood swings (depression), skin changes (pale skin), shortness of breath, or fast heart rate

On the Ballestas Islands & Huacachina tour, youll see sea lions, penguins, pelicans, and the El Candelabro geoglyph from a boat

Deficiency leads to nerve damage (neuropathy), which presents as numbness, tingling, or weakness

Patients should be referred urgently if they have neurological symptoms, if the diagnosis is unclear, or if there is inadequate clinical response to treatment