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B12 has many functions in our body, so unfortunately a deficiency will give rise to a wide variety of symptoms, like ‘brain fog’, memory problems, cognitive impairment, insomnia, headaches, especially migraine, behavioural changes, learning problems, nominal aphasia, mood swings, irritability, depression, anxiety, hallucinations, delusions, psychosis, peripheral paraesthesia (‘pins and needles’), numbness, neuropathic pains, poor balance, reduced vibration sense or proprioception (joint position sense), tinnitus, ataxia, taste impairment, sometimes myelopathy, fatigue, anaemia (either with larger red blood cells, or with normal size of the red blood cells when there is also iron deficiency), other reduction in blood cells, abdominal complaints, malabsorption, failure to thrive, weight loss, diarrhoea, hyperpigmentation, glossitis, (aphthous) stomatitis, infertility, urinary tract infections, joint and muscle pain, muscle weakness, spasticity, seizures, cardiomyopathy, urinary and/or faecal incontinence, postural hypotension/dizziness, erectile dysfunction, to name a few

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Stier, Vos and Kenley (J Endocrinol Metab, 2013) summarised six randomised, double-blind, placebo-controlled trials — phase I intravenous dose-ranging through to two phase 2b efficacy studies of 12 and 24 weeks in 300 and 502 obese adults respectively